title: Virtual reality robotic surgery simulation curriculum to teach robotic suturing: a randomized controlled trial.
abstract: The objective of this randomized, controlled trial was to assess whether voluntary participation in a proctored, proficiency-based, virtual reality robotic suturing curriculum using the da Vinci(®) Skills Simulator™ improves robotic suturing performance. Residents and attending surgeons were randomized to participation or non-participation during a 5 week training curriculum. Robotic suturing skills were evaluated before and after training using an inanimate vaginal cuff model, which participants sutured for 10 min using the da Vinci(®) Surgical System. Performances were videotaped, anonymized, and subsequently graded independently by three robotic surgeons. 27 participants were randomized. 23 of the 27 completed both the pre- and post-test, 13 in the training group and 10 in the control group. Mean training time in the intervention group was 238 ± 136 min (SD) over the 5 weeks. The primary outcome (improvement in GOALS+ score) and the secondary outcomes (improvement in GEARS, total knots, satisfactory knots, and the virtual reality suture sponge 1 task) were significantly greater in the training group than the control group in unadjusted analysis. After adjusting for lower baseline scores in the training group, improvement in the suture sponge 1 task remained significantly greater in the training group and a trend was demonstrated to greater improvement in the training group for the GOALS+ score, GEARS score, total knots, and satisfactory knots.
authors.affiliation: Experimental Surgery, McGill University, Montreal, Canada. danieljameskiely@gmail.com.|Gynecologic Oncology, University of Montreal, Montreal, Canada. danieljameskiely@gmail.com.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kiely
authors.affiliation: Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
authors.affiliation: Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Susie
authors.initials: S
authors.lastname: Lau
authors.affiliation: Gynecologic Oncology, Royal Victoria Hospital, McGill University, Montreal, Canada.
authors.forename: Xing
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Gynecologic Oncology, University of Montreal, Montreal, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Samouelian
authors.affiliation: Epidemiology, McGill University, Montreal, Canada.
authors.forename: Agnihotram V
authors.initials: AV
authors.lastname: Ramanakumar
authors.affiliation: Experimental Surgery, McGill University, Montreal, Canada.
authors.forename: Helena
authors.initials: H
authors.lastname: Zakrzewski
authors.affiliation: Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Sonya
authors.initials: S
authors.lastname: Brin
authors.affiliation: General Surgery, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Fraser
authors.affiliation: Obstetrics and Gynecology, McGill University, Montreal, Canada.
authors.forename: Pira
authors.initials: P
authors.lastname: Korsieporn
authors.affiliation: Vascular Surgery, McGill University, Montreal, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Drudi
authors.affiliation: Division of Oncology and Pelvic Surgery, Pacific Gynecology Specialists, Seattle, USA.
authors.forename: Joshua Z
authors.initials: JZ
authors.lastname: Press
mesh_terms: D000328:Adult; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D065287:Robotic Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D066231:Surgeons / Q000193:education*; D013536:Suture Techniques / Q000193:education* / Q000295:instrumentation*; D014584:User-Computer Interface
keywords: Computer simulation; Graduate medical education; Operative surgical procedures; Patient simulation; Randomized controlled trial; Robotics