First Simulation-Based Robotic Surgery Curriculum Successful

According to a study published in Urology, those trained with the Fundamental Skills of Robotic Surgery curriculum demonstrated greater precision in surgical skills than those who did not receive training.

The curriculum makes use of the Robotic Surgical Simulator (RoSS), one of the first simulators to accurately mimic the da Vinci Surgical System.

RoSS was developed by two of the curriculum study researchers: senior author Khurshid A. Guru, MD, who directs robotic surgery at Roswell Park Comprehensive Cancer Center, and co-author Thenkurussi Kesavadas, PhD, who directs UB’s Virtual Reality Lab and is a professor of mechanical and aerospace engineering.

Recruited from UB, Roswell Park, the Henry Ford Health System in Detroit and the Cleveland Clinic, 53 surgeons, fellows, residents and medical students participated in the study. Most had no prior robotic or laparoscopic surgical experience.

Initially, an experimental group completed the four-hour training course while a control group did not.

When tested on the da Vinci system, the trained group performed three tasks with more precision and speed than the control group.

Twenty-three control participants then also completed the training. When they were re-tested on the same tasks, their average performance improved considerably.

The researchers now plan further study to establish the extent to which their robotic surgery curriculum may affect long-term surgical proficiency.

Already, this pioneering curriculum “is being used in many leading robotic surgery training programs nationally and internationally,” says Kesavadas.

Guru notes it is “critically important” to have training programs that realistically simulate the surgical environment and build user proficiency in core skills.

This study “gives us the first evidence that a carefully designed, structured training curriculum carried out in a risk-free, simulated environment is an effective way to translate the basic skills required in robot-assisted surgery,” he says.

“The implications for improvements in patient safety and long-term outcomes are tremendously encouraging.”

Other UB co-authors on the study are James M. Hassett, MD, professor of surgery; Ashirwad Chowriappa, computer science doctoral candidate; and Gregory E. Wilding, PhD, associate professor of biostatistics and Roswell Park's vice-chair for biostatistics.

Additional coauthors are from the study’s other participating institutions in Buffalo, Detroit and Cleveland, as well as King’s College, London.

The RoSS simulator and the curriculum were developed, tested and validated with support from the John R. Oishei Foundation and the Roswell Park Alliance Foundation, both in Buffalo.