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Citation
Tags
HERO ID
7117636
Reference Type
Journal Article
Title
Skills in minimally invasive and open surgery show limited transferability to robotic surgery: results from a prospective study
Author(s)
Kowalewski, KF; Nickel, F; Schmidt, MW; Proctor, T; Pohl, M; Wennberg, E; Karadza, E; Romero, P; Kenngott, HG; Mueller-Stich, BP; ,
Year
2018
Is Peer Reviewed?
1
Journal
Surgical Endoscopy
ISSN:
0930-2794
EISSN:
1432-2218
Publisher
SPRINGER
Location
NEW YORK
Page Numbers
1656-1667
PMID
29435749
DOI
10.1007/s00464-018-6109-0
Web of Science Id
WOS:000427159300003
Abstract
There is limited evidence on the transferability of conventional laparoscopic and open surgical skills to robotic-assisted surgery. The primary aim of this study was to evaluate the transferability of expertise in conventional laparoscopy and open surgery to robotic-assisted surgery using the da Vinci Skills Simulator (dVSS). Secondary aims included evaluating the influence of individual participants' characteristics.Participants performed four tasks on the dVSS: Peg Board 1 (PB), Pick and Place (PP), Thread the Rings (TR), and Suture Sponge 1 (SS). Participants were classified into three groups (Novice, Intermediate, Experts) according to experience in laparoscopic and open surgery. All tasks were performed twice except for SS. Performance was assessed using the built-in scoring system.37 medical students and 25 surgeons participated. Experts did not perform significantly better than less experienced participants on the dVSS. Specifically, with regard to laparoscopic experience, total simulator scores were: Novices 68.2 +/- 28.8; Intermediates 65.1 +/- 31.2; Experts 65.1 +/- 30.0; p = 0.611. Regarding open surgical experience, scores were: Novices 68.6 +/- 28.7; Intermediates 68.2 +/- 30.8; Experts 63.2 +/- 30.3; p = 0.305. Although there were some significant differences among groups for single parameters in specific tasks, there was no constant superiority of one group. Laparoscopic and open surgical Novices improved significantly in overall score and time for all three tasks (p < 0.05). Laparoscopic intermediates improved only in PP time (4.64 +/- 3.42; p = 0.006), open Intermediates in PB score (11.98 +/- 13.01; p = 0.025), and open Experts in PP score (6.69 +/- 11.48; p = 0.048). Laparoscopic experts showed no improvement. Participants with gaming experience had better overall scores than non-gamers when comparing all second attempts (Gamer 83.62 +/- 7.57; Non-Gamer 76.31 +/- 12.78; p = 0.008) as well as first and second attempts together (Gamer 72.08 +/- 8.86; Non-Gamer 65.45 +/- 11.68; p = 0.039). Musical and sports experience showed no correlation with robotic performance.Robotic-assisted surgery requires skills distinct from conventional laparoscopy or open surgery. Basic robotic skills training prior to patient contact should be required.
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