title: Contribution of laparoscopic training to robotic proficiency.
abstract: OBJECTIVE
  Robotic surgical technology has been adopted by surgeons with and without previous standard laparoscopic experience. The necessity or benefit of prior training and experience in laparoscopic surgery is unknown. We hypothesized that laparoscopic training enhances performance in robotic surgery.
  
  
  METHODS
  Fourteen medical students with no surgical experience were instructed to incise a spiral using the da Vinci(®) surgical robot with time to completion and errors recorded. Each student was then trained for 1 month in standard laparoscopy, but with no further robotic exposure. Training included a validated laparoscopic training program, including timed and scored parameters. After completion of the month-long training, the students repeated the cutting exercise using the da Vinci robot as well as with standard laparoscopic instruments and were scored within the same parameters.
  
  
  RESULTS
  The mean time to completely incise the spiral robotically before training was 16.72 min with a mean of 6.21 errors. After 1 month of validated laparoscopic training, the mean robotic time fell to 9:03 min (p=0.0002) with 3.57 errors (p=0.02). Laparoscopic performance after 1 month of validated laparoscopic training was 13.95 min with 6.14 errors, which was no better than pretraining robotic performance (p=0.20) and worse than post-training robotic performance (p=0.01).
  
  
  CONCLUSIONS
  Formal laparoscopic training improved the performance of a complex robotic task. The initial robotic performance without any robotic or laparoscopic training was equivalent to standard laparoscopic performance after extensive training. Additionally, after laparoscopic training, the robot allowed significantly superior speed and precision of the task. Laparoscopic training may improve the proficiency in operation of the robot. This may explain the perceived ease with which robotics is adopted by laparoscopically trained surgeons and may be important in training future robotic surgeons.
authors.affiliation: Department of Urology, James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA. Jordan.angell@osumc.edu
authors.forename: Jordan
authors.initials: J
authors.lastname: Angell
authors.forename: Michael S
authors.initials: MS
authors.lastname: Gomez
authors.forename: Mirza M
authors.initials: MM
authors.lastname: Baig
authors.forename: Ronney
authors.initials: R
authors.lastname: Abaza
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D012371:Robotics / Q000193:education* / Q000295:instrumentation; D013520:Urologic Surgical Procedures / Q000193:education* / Q000379:methods