Title : ReSET Robotics: Remodelling Surgical Education and Training in Robotics
Abstract:
Introduction and Objective
The Halstedian apprenticeship training model needs refashioning in a digital technology age. We introduce a novel online, virtual reality and synthetic organ simulation training program for robotic surgery.
Methods
Surgical trainees from urology, general, colorectal, and gynaecology undertook a four pillared education program. This included 9 online modules teaching the theory and principles of robotic surgery. Then hands-on training using Mimic virtual reality simulators to assess and score psychomotor skills and innate ability. A curated dual console experience was created using live 3D stereoscopic video uploaded to Oculus headsets prior to progression to the operating room. Trainees commenced operating room training using high-fidelity 3D printed hydrogel organ models containing clinically relevant objective surgical metrics and video review. Finally, mentored live surgery with access to cloud-based video review was provided.
Results
32 participants completed the online course averaging 8 hours. Pre and post course surveys demonstrated increased confidence in robotic technology and ability to perform surgical assisting and console procedures. 9 trainees completed a virtual reality innate ability curriculum on Mimic simulators. Time to proficiency ranged 38 to 98 minutes. Robotic radical prostatectomy operative steps were demonstrated in 3D using virtual reality headsets. 2 expert and 2 novice robotic surgeons completed 3D printed pelvic node dissection and radical prostatectomy models. Blood loss, anastomosis integrity, nerve strain, positive margins and operative time were recorded. Live surgical footage was uploaded to a cloud-based video platform for remote assessment by a faculty of expert robotic surgeons.
Conclusions
A new method for robotic surgical training that uses digital and synthetic organ technology now enables a shift away from a Halstedian method of training that relies on cadavers, animals and learning on live patients.
