Assessment of the training program for Versius, a new innovative robotic system for use in minimal access surgery

ObjectivesThe Versius surgical system has been developed for use in robot-assisted minimal access surgery (MAS). This study aimed to evaluate the effectiveness of the Versius training program.DesignA 3.5-day program following 10 hours of online didactic training. Participants were assessed during the technical training using the Global Evaluative Assessment of Robotic Skills (GEARS).SettingDry box exercises were conducted in classrooms, and wet lab sessions simulated an operating room environment using cadaveric specimens.ParticipantsSeventeen surgical teams participated; surgeons represented general, colorectal, obstetrics/gynecology, and urology specialties. All surgeons had previous laparoscopic MAS experience, while experience with robotics varied.Main outcomes measuresParticipants were scored on a five-point Likert Scale for each of six validated GEARS domains (depth perception, bimanual dexterity, efficiency, force sensitivity, autonomy, and robotic control). Additional metrics used to chart surgeon performance included: combined instrument path length; combined instrument angular path; and time taken to complete each task.ResultsParticipants demonstrated an overall improvement in performance during the study, with a mean GEARS Score of 21.0 (SD: 1.9) in Assessment 1 increasing to 23.4 (SD: 2.9) in Validation. Greatest improvements were observed in the depth perception and robotic control domains. Greatest differences were observed when stratifying by robotic experience; those with extensive experience consistently scored higher than those with some or no experience.ConclusionsThe Versius training program is effective; participants were able to successfully operate the system by program completion, and more surgeons achieved intermediate-level and expert-level GEARS scores in Validation compared with Assessment 1.

Surgical Education in the 21st Century

Surgical education has evolved drastically since the 19th century. Previously education of surgical residents was limited to on job clinical training following the “see one, do one, teach one” model with knowledge gleaned from textbooks and journals. Presently a growing emphasis has been placed on both patient safety and resident well-being leading to a development of novel training paradigms. The textbook, while remaining a core source of knowledge, is now only one of many resources available to residents. Many residencies have their libraries online, making learning possible almost anywhere, even without physical books in hand. Most programs now incorporate education days where a structured curriculum allows for standardized education; this makes it less likely that residents miss out on mandatory concepts. The 2020 Covid-19 pandemic has led to further evolution of this model, making the classroom virtual yet interactive. Technology has allowed for residents to train on surgical simulators, so that laparoscopic and robotic skills may be practiced before application on a live patient. Altogether residents are afforded multiple ways to learn due to greater availability of time, structured educational modules, and technology.

Flexible Robotic Assembly Based on Ontological Representation of Tasks, Skills, and Resources

Technology has sufficiently matured to enable, in principle, flexible and autonomous robotic assembly systems. However, in practice, it requires making all the relevant (implicit) knowledge that system engineers and workers have – about products to be assembled, tasks to be performed, as well as robots and their skills – available to the system explicitly. Only then can the planning and execution components of a robotic assembly pipeline communicate with each other in the same language and solve tasks autonomously without human intervention. This is why we have developed the Factory of the Future (FoF) ontology. At its core, this ontology models the tasks that are necessary to assemble a product and the robotic skills that can be employed to complete said tasks. The FoF ontology is based on existing standards. We started with theoretical considerations and iteratively adapted it based on practical experience gained from incorporating more and more components required for automated planning and assembly. Furthermore, we propose tools to extend the ontology for specific scenarios with knowledge about parts, robots, tools, and skills from various sources. The resulting scenario ontology serves us as world model for the robotic systems and other components of the assembly process. A central runtime interface to this world model provides fast and easy access to the knowledge during execution. In this work, we also show the integration of a graphical user front-end, an assembly planner, a workspace reconfigurator, and more components of the assembly pipeline that all communicate with the help of the FoF ontology. Overall, our integration of the FoF ontology with the other components of a robotic assembly pipeline shows that using an ontology is a practical method to establish a common language and understanding between the involved components.

1420 ViRtual prOficiency Based prOgression for Robotic Training (VROBOT): A Prospective Cohort Study Protocol

Introduction Robotic surgery is an evolving field that requires specialist training. Historically, robotic surgery training has lacked standardisation. Recently, training centres have introduced proficiency-based modules and curriculums to certify and progress the skills of novice robotic surgeons. However, training tends to be self-directed and non-interactive. Limited interactive teaching does exist but can be inaccessible and expensive. We aim to validate the effectiveness of the current Fundamentals of Robotic Surgery (FRS) training curriculum with the addition of interactive virtual classroom teaching. Method 16 novice surgical trainees will be assigned to two training groups. The interventions will be implemented following a one-week robotic skills induction. Both groups will receive access to the FRS curriculum for one week. The intervention group will additionally receive virtual classroom robotic skills training. The primary outcome will be the objective performance scores after training using a synthetic model based on task errors, time taken and contact pressure. In week 3, each group will receive the alternate intervention and objective performance scores will be measured to determine the trajectory of scores. Results Significant objective performance improvement following the intervention will be indicative of intervention quality. Conclusions This will be the first feasibility study evaluating the efficacy of interactive virtual robotic surgery training. It will determine the effect size of virtual classroom training on the development of basic robotic surgical skills in addition to the proficiency-based FRS curriculum. The findings will assist the development and implementation of further resource-efficient virtual robotic surgical skills training programs.

Is laparoscopic experience helpful in simulator based robotic training in general surgery?

Objective: To evaluate whether or not prior laparoscopic training improves performance during robotic surgery utilising DaVinci robotic skills simulator. Methods: The cross-sectional study was conducted at the Civil Hospital, Karachi, from May 4 to November 11, 2018, and comprised first year residents in Group A with no laparoscopic skills and fourth year residents doing laparoscopic cholecystectomy independently and surgical faculty members in Group B who had laparoscopic skills. Both the groups had no previous exposure to robotic surgery and skills simulator. There were 4 exercises which were repeated three times by each participant. Scoring was done using the the DaVinci robotic skills simulator software. Data was analysed using SPSS 22. Results: Of the 30 surgeons, there were 15(50%) in Group A with a mean age of 26±0.56 years, and 15(50%) in Group B with a mean age of 32 years± 9.16 (p<0.001). The overall mean age was 32±9.16 years (range: 25-52 years). There were 19(63.3) females in the sample compared to 11(36.6%) males. Mean scores of Ring walk 2, Peg board 2, and Suture sponge 3 were better in Group A, while mean score of Matchboard 2 was better in Group although B (p>0.05). Group B fared better in the individual scoring of Suture sponge 2 (p>0.05). Conclusion: Laparoscopic skills apparently did not confer any benefit while performing exercises on the DaVinci skills simulator. Key Words: DaVinci Si, DaVinci skills simulator, dVSSS, Robotic surgery curriculum, Robotic surgery simulation. Continuous...

A Nurse Training Program for Robotic Skills Acquisition and Career Advancement

Objective: Robotic surgery presents the state of the art surgical techniques in the era of minimally invasive surgery. A nurse’s role in surgery has been altered with the development of robotics. Our unique program at Polk State College in Florida was a robotic nursing program in which we certified nurses after a great deal of training. In this study our goal was to assess the survey outcomes of this program and to see if there was room for any improvements. Materials and Methods: We have successfully completed 4 three-day courses. During these courses we trained a total of 30 nurses and technicians. This special three-day course involved learning through online modules, didactic education, hands on training, and live surgery. We asked for their response to various questions about the course through an online survey. The trainees were asked to rank the questions about the program. Results: We obtained 20 out of 30 responses from our certified trainees. Seventy-five percent of the certified trainees agree that this robotics nursing program has helped them advance in a career. Overall, 85% of the certified trainees stated that this program was beneficial to them, and 95% agree that they would recommend this robotic nursing program to others. Conclusion: This survey demonstrated a well-designed robotics nurse-training program might help trainees to gain robotic skills. Also, they declared that their certification helped them make some kind of advance in their career.