title: Comparison of two simulation systems to support robotic-assisted surgical training: a pilot study (Swine model).
abstract: OBJECTIVE
  To compare the efficacy of simulation-based training between the Mimic dV- Trainer and traditional dry lab da Vinci robot training.
  
  
  METHODS
  A prospective randomized study analyzing the performance of 20 robotics-naive participants. Participants were enrolled in an online da Vinci Intuitive Surgical didactic training module, followed by training in use of the da Vinci standard surgical robot. Spatial ability tests were performed as well. Participants were randomly assigned to 1 of 2 training conditions: performance of 3 Fundamentals of Laparoscopic Surgery dry lab tasks using the da Vinci or performance of 4 dV-Trainer tasks. Participants in both groups performed all tasks to empirically establish proficiency criterion. Participants then performed the transfer task, a cystotomy closure using the daVinci robot on a live animal (swine) model. The performance of robotic tasks was blindly assessed by a panel of experienced surgeons using objective tracking data and using the validated Global Evaluative Assessment of Robotic Surgery (GEARS), a structured assessment tool.
  
  
  RESULTS
  No statistically significant difference in surgeon performance was found between the 2 training conditions, dV-Trainer and da Vinci robot. Analysis of a 95% confidence interval for the difference in means (-0.803 to 0.543) indicated that the 2 methods are unlikely to differ to an extent that would be clinically meaningful.
  
  
  CONCLUSIONS
  Based on the results of this study, a curriculum on the dV- Trainer was shown to be comparable to traditional da Vinci robot training. Therefore, we have identified that training on a virtual reality system may be an alternative to live animal training for future robotic surgeons.
authors.affiliation: Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Sabrina V
authors.initials: SV
authors.lastname: Whitehurst
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Electronic address: ernest.lockrow@usuhs.edu.
authors.forename: Ernest G
authors.initials: EG
authors.lastname: Lockrow
authors.affiliation: Department of Urology, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lendvay
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Propst
authors.affiliation: Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Dunlow
authors.affiliation: Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rosemeyer
authors.affiliation: Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Gobern
authors.affiliation: Bioengineering Department, University of Washington, Seattle, Washington.
authors.forename: Lee W
authors.initials: LW
authors.lastname: White
authors.affiliation: Anthotronix, Silver Spring, Maryland.
authors.forename: Anna
authors.initials: A
authors.lastname: Skinner
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Buller
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D053715:Cystotomy / Q000379:methods; D004521:Educational Measurement; D006801:Humans; D010535:Laparoscopy / Q000193:education / Q000379:methods; D023421:Models, Animal; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D012371:Robotics; D013552:Swine; D013647:Task Performance and Analysis; D014584:User-Computer Interface
keywords: Robotic surgery; Simulation; Virtual reality; dV-Trainer; da Vinci Surgical System