Lucian Panait1, Shohan Shetty2, Patricia A Shewokis3, Juan A Sanchez4. 1. The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut; Drexel University College of Medicine, Philadelphia, Pennsylvania. 2. The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut. Electronic address: shohan_shetty@hotmail.com. 3. Drexel University, Department of Nutrition Sciences, College of Nursing and Health Professions, Philadelphia, Pennsylvania; Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, Pennsylvania. 4. The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut; St. Agnes Healthcare, Baltimore, Maryland.
Abstract
BACKGROUND: Identifying the set of skills that can transfer from laparoscopic to robotic surgery is an important consideration in designing optimal training curricula. We tested the degree to which laparoscopic skills transfer to a robotic platform. METHODS: Fourteen medical students and 14 surgery residents with no previous robotic but varying degrees of laparoscopic experience were studied. Three fundamentals of laparoscopic surgery tasks were used on the laparoscopic box trainer and then the da Vinci robot: peg transfer (PT), circle cutting (CC), and intracorporeal suturing (IS). A questionnaire was administered for assessing subjects' comfort level with each task. RESULTS: Standard fundamentals of laparoscopic surgery scoring metric were used and higher scores indicate a superior performance. For the group, PT and CC scores were similar between robotic and laparoscopic modalities (90 versus 90 and 52 versus 47; P > 0.05). However, for the advanced IS task, robotic-IS scores were significantly higher than laparoscopic-IS (80 versus 53; P < 0.001). Subgroup analysis of senior residents revealed a lower robotic-PT score when compared with laparoscopic-PT (92 versus 105; P < 0.05). Scores for CC and IS were similar in this subgroup (64 ± 9 versus 69 ± 15 and 95 ± 3 versus 92 ± 10; P > 0.05). The robot was favored over laparoscopy for all drills (PT, 66.7%; CC, 88.9%; IS, 94.4%). CONCLUSIONS: For simple tasks, participants with preexisting skills perform worse with the robot. However, with increasing task difficulty, robotic performance is equal or better than laparoscopy. Laparoscopic skills appear to readily transfer to a robotic platform, and difficult tasks such as IS are actually enhanced, even in subjects naive to the technology.
BACKGROUND: Identifying the set of skills that can transfer from laparoscopic to robotic surgery is an important consideration in designing optimal training curricula. We tested the degree to which laparoscopic skills transfer to a robotic platform. METHODS: Fourteen medical students and 14 surgery residents with no previous robotic but varying degrees of laparoscopic experience were studied. Three fundamentals of laparoscopic surgery tasks were used on the laparoscopic box trainer and then the da Vinci robot: peg transfer (PT), circle cutting (CC), and intracorporeal suturing (IS). A questionnaire was administered for assessing subjects' comfort level with each task. RESULTS: Standard fundamentals of laparoscopic surgery scoring metric were used and higher scores indicate a superior performance. For the group, PT and CC scores were similar between robotic and laparoscopic modalities (90 versus 90 and 52 versus 47; P > 0.05). However, for the advanced IS task, robotic-IS scores were significantly higher than laparoscopic-IS (80 versus 53; P < 0.001). Subgroup analysis of senior residents revealed a lower robotic-PT score when compared with laparoscopic-PT (92 versus 105; P < 0.05). Scores for CC and IS were similar in this subgroup (64 ± 9 versus 69 ± 15 and 95 ± 3 versus 92 ± 10; P > 0.05). The robot was favored over laparoscopy for all drills (PT, 66.7%; CC, 88.9%; IS, 94.4%). CONCLUSIONS: For simple tasks, participants with preexisting skills perform worse with the robot. However, with increasing task difficulty, robotic performance is equal or better than laparoscopy. Laparoscopic skills appear to readily transfer to a robotic platform, and difficult tasks such as IS are actually enhanced, even in subjects naive to the technology.
Authors: Lee J Moore; Mark R Wilson; John S McGrath; Elizabeth Waine; Rich S W Masters; Samuel J Vine Journal: Surg Endosc Date: 2014-11-27 Impact factor: 4.584
Authors: Daniel G Davila; Melissa C Helm; Matthew J Frelich; Jon C Gould; Matthew I Goldblatt Journal: Surg Endosc Date: 2017-12-06 Impact factor: 4.584