The transferability of virtual reality simulation-based robotic suturing skills to a live porcine model in novice surgeons: a single blind randomized controlled trial1

• Published in: Journal of minimally invasive gynecology
• Main Authors: Vargas, Maria V., MD, Moawad, Gaby, MD, Denny, Kathryn, Happ, Lindsey, MPH, Misa, Nana Yaa, Margulies, Samantha, MD, Opoku-Anane, Jessica, MD, Abi Khalil, Elias, MD, Marfori, Cherie, MD
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Obstetrics and Gynecology; Surgery; Robotic surgery; proficiency based training; daVinci Surgical Simulator; simulation; da Vinci Surgical System; virtual reality simulation
• ISSN: 1553-4650
• DOI: 10.1016/j.jmig.2016.12.016

Abstract Objective To assess whether a robotic simulation curriculum for novice surgeons can improve performance of a suturing task in a live porcine model. Design Randomized controlled trial: (Canadian Task Force Classification I) Setting Academic medical center Patients 35 medical students without robotic surgical experience Interventions Participants were enrolled in an online session of training modules followed by an in-person orientation. Baseline performance testing on the Mimic Technologies daVinci Surgical Simulator (dVSS) was also performed. Participants were then randomly assigned to the completion of 4 dVSS training tasks (Camara clutching 1, Suture sponge 1 and 2, and Tubes) versus no further training. The intervention group performed each dVSS task until proficiency or up to 10 times. A final suturing task was performed on a live porcine model, which was video recorded and blindly assessed by experienced surgeons. The primary outcomes were Global Evaluative Assessment of Robotic Skills (GEARS) scores and task time. The study had 90% power to detect a mean difference of 3 points on the GEARS scale, assuming a standard deviation (SD) of 2.65, and 80% power to detect a mean difference of 3 minutes, assuming a SD of 3 minutes. Measurements & Main Results There were no differences in demographics and baseline skills between the two groups. No significant differences in task time in minutes or GEARS scores were seen for the final suturing task between the intervention and control groups respectively (9.2(2.65) versus 9.9(2.07) minutes; p=0.406 and 15.37(2.51) versus 15.25(3.38); p=.603). The 95% confidence interval for the difference in mean task times was -2.36 to 0.96 minutes, and mean GEARS scores was -1.91 to 2.15 points. Conclusions Live suturing task performance was not improved with a proficiency-based virtual reality simulation suturing curriculum compared to standard orientation to the daVinci robotic console in a group of novice surgeons.