Roberto Vanin Pinto Ribeiro1,2, João Maximiliano3, Guilherme Barreiro4, Olavo Haas de Souza Gastal5, Pauline Simas Machado6, Luciano Paludo Marcelino6, Henrique Rasia Bosi7, Eduardo Madalosso Zanin8, Leandro Totti Cavazzola6. 1. Division of Cardiovascular Surgery, Department of Surgery, University of Toronto, Toronto, Canada. 2. Division of Cardiovascular Surgery, Department of Surgery, Dalhousie University, Halifax, Canada. 3. Division of Plastic Surgery, Department of Surgery, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, RS, 90035-007, Brazil. jmaximilianopm@gmail.com. 4. Department of Surgery, Universidade Federal do Mato Grosso, Sinop, Brazil. 5. Department of Anesthesiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 6. Division of General Surgery, Department of Surgery, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 7. Division of Digestive and General Surgery, Department of Surgery, Hospital Geral de Caxias do Sul, Universidade de Caxias do Sul, Caxias do Sul, Brazil. 8. Division of Plastic Surgery, Department of Surgery, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, RS, 90035-007, Brazil.
Abstract
BACKGROUND: Robotic surgery is a valid option for minimally invasive surgery in most surgical specialties. However, the need to master laparoscopy is questionable before starting specific training in robotic surgery. We compared the development of basic robotic surgery skills between individuals randomized to train in conventional, laparoscopic, or robotic skills. METHODS: We conducted a single-centered, single-blinded randomized trial. Medical students were randomly assigned to 20 h of conventional, laparoscopic, or robotic surgical training. Students with previous surgical experience were excluded. Participants were evaluated pre- and post-training on the dV-Trainer robotic surgical simulator with the following exercises: Camera Targeting 1, Peg Board 1, Ring and Rail 1, and Ring and Rail 2. RESULTS: Sixty-six students were randomly assigned to each training group. Eight individuals did not complete the study (2 in the conventional group, 3 in the laparoscopic group, and 3 in the robotic group). All groups demonstrated significant improvement in the composite score and in each task following the training period (p < 0.001). No differences were seen between the conventional and laparoscopic groups in the composite score or individual tasks. The robotic group showed greater improvement in number of errors, economy of motion, workspace utilization, and time for completion compared to the other groups. The laparoscopic group showed improved camera manipulation skills compared to the conventional group, while the conventional group showed improved errors and economy of motion compared to the laparoscopic group. CONCLUSION: There was no difference in the acquisition of basic robotic surgical skills between individuals trained in basic conventional or laparoscopic surgical skills. We believe surgeons mastery in laparoscopy is not needed before initiating robotic surgical training. However, basic principles of laparoscopy remain applicable to robotic surgery. Future studies should compare transferability of conventional and laparoscopic training to robotic skills in the operating room.
BACKGROUND: Robotic surgery is a valid option for minimally invasive surgery in most surgical specialties. However, the need to master laparoscopy is questionable before starting specific training in robotic surgery. We compared the development of basic robotic surgery skills between individuals randomized to train in conventional, laparoscopic, or robotic skills. METHODS: We conducted a single-centered, single-blinded randomized trial. Medical students were randomly assigned to 20 h of conventional, laparoscopic, or robotic surgical training. Students with previous surgical experience were excluded. Participants were evaluated pre- and post-training on the dV-Trainer robotic surgical simulator with the following exercises: Camera Targeting 1, Peg Board 1, Ring and Rail 1, and Ring and Rail 2. RESULTS: Sixty-six students were randomly assigned to each training group. Eight individuals did not complete the study (2 in the conventional group, 3 in the laparoscopic group, and 3 in the robotic group). All groups demonstrated significant improvement in the composite score and in each task following the training period (p < 0.001). No differences were seen between the conventional and laparoscopic groups in the composite score or individual tasks. The robotic group showed greater improvement in number of errors, economy of motion, workspace utilization, and time for completion compared to the other groups. The laparoscopic group showed improved camera manipulation skills compared to the conventional group, while the conventional group showed improved errors and economy of motion compared to the laparoscopic group. CONCLUSION: There was no difference in the acquisition of basic robotic surgical skills between individuals trained in basic conventional or laparoscopic surgical skills. We believe surgeons mastery in laparoscopy is not needed before initiating robotic surgical training. However, basic principles of laparoscopy remain applicable to robotic surgery. Future studies should compare transferability of conventional and laparoscopic training to robotic skills in the operating room.
Authors: Pier Cristoforo Giulianotti; Andrea Coratti; Fabio Sbrana; Pietro Addeo; Francesco Maria Bianco; Nicolas Christian Buchs; Mario Annechiarico; Enrico Benedetti Journal: Surgery Date: 2010-06-08 Impact factor: 3.982
Authors: Nicolas Christian Buchs; Pietro Addeo; Francesco Maria Bianco; Subhashini Ayloo; Enrico Benedetti; Pier Cristoforo Giulianotti Journal: World J Surg Date: 2011-12 Impact factor: 3.352
Authors: Quoc-Dien Trinh; Jesse Sammon; Maxine Sun; Praful Ravi; Khurshid R Ghani; Marco Bianchi; Wooju Jeong; Shahrokh F Shariat; Jens Hansen; Jan Schmitges; Claudio Jeldres; Craig G Rogers; James O Peabody; Francesco Montorsi; Mani Menon; Pierre I Karakiewicz Journal: Eur Urol Date: 2011-12-22 Impact factor: 20.096
Authors: Nicolas C Buchs; Pietro Addeo; Francesco M Bianco; Veronica Gorodner; Subhashini M Ayloo; Enrique F Elli; José Oberholzer; Enrico Benedetti; Pier C Giulianotti Journal: Arch Surg Date: 2012-08
Authors: Pier Cristoforo Giulianotti; Pietro Addeo; Nicolas Christian Buchs; Subhashini M Ayloo; Francesco Maria Bianco Journal: Pancreas Date: 2011-11 Impact factor: 3.327