title: Do laparoscopic skills transfer to robotic surgery?
abstract: BACKGROUND
  Identifying the set of skills that can transfer from laparoscopic to robotic surgery is an important consideration in designing optimal training curricula. We tested the degree to which laparoscopic skills transfer to a robotic platform.
  
  
  METHODS
  Fourteen medical students and 14 surgery residents with no previous robotic but varying degrees of laparoscopic experience were studied. Three fundamentals of laparoscopic surgery tasks were used on the laparoscopic box trainer and then the da Vinci robot: peg transfer (PT), circle cutting (CC), and intracorporeal suturing (IS). A questionnaire was administered for assessing subjects' comfort level with each task.
  
  
  RESULTS
  Standard fundamentals of laparoscopic surgery scoring metric were used and higher scores indicate a superior performance. For the group, PT and CC scores were similar between robotic and laparoscopic modalities (90 versus 90 and 52 versus 47; P > 0.05). However, for the advanced IS task, robotic-IS scores were significantly higher than laparoscopic-IS (80 versus 53; P < 0.001). Subgroup analysis of senior residents revealed a lower robotic-PT score when compared with laparoscopic-PT (92 versus 105; P < 0.05). Scores for CC and IS were similar in this subgroup (64 ± 9 versus 69 ± 15 and 95 ± 3 versus 92 ± 10; P > 0.05). The robot was favored over laparoscopy for all drills (PT, 66.7%; CC, 88.9%; IS, 94.4%).
  
  
  CONCLUSIONS
  For simple tasks, participants with preexisting skills perform worse with the robot. However, with increasing task difficulty, robotic performance is equal or better than laparoscopy. Laparoscopic skills appear to readily transfer to a robotic platform, and difficult tasks such as IS are actually enhanced, even in subjects naive to the technology.
authors.affiliation: The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut; Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Lucian
authors.initials: L
authors.lastname: Panait
authors.affiliation: The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut. Electronic address: shohan_shetty@hotmail.com.
authors.forename: Shohan
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Drexel University, Department of Nutrition Sciences, College of Nursing and Health Professions, Philadelphia, Pennsylvania; Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, Pennsylvania.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Shewokis
authors.affiliation: The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut; St. Agnes Healthcare, Baltimore, Maryland.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Sanchez
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy / Q000193:education*; D012371:Robotics / Q000193:education*; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: FLS; Laparoscopy; Robotic surgery; Simulation training; Surgical education