Acquisition of robotic surgical skills by surgical residents is usually hindered by time pressure and financial imperatives. Robotic simulation training offers an attractive solution because it allows residents to learn in a safe, controlled, and standardized environment. We aimed to determine the confidence levels of senior surgical residents with the robotic platform, and how those levels were affected by simulation training. Twenty senior residents participated in a simulation course using perfused porcine tissue blocks to perform the following robotic procedures: Nissen fundoplication, Heller myotomy, sleeve gastrectomy, colectomy, and lobectomy. Procedural steps evaluated included port placements, docking process, suturing, using energy devices, and using staplers. Mean baseline confidence levels were low for all the surgical steps analyzed, and all these values significantly increased after the 3-day robotic training in the simulation center. A standardized formal robotic simulation program with realistic hands-on training should be incorporated in the general surgery residency curriculum.
Robotic surgery Residents Training Simulation
This is a preview of subscription content, log in to check access.
Compliance with ethical standards
Conflict of interest
Francisco Schlottmann, Jason M. Long, Sean Brown, and Marco G. Patti declare that they have no conflict of interest.
All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
Statement of human and animal rights
This study does not contain any studies with human participants performed by any of the authors.
Jeong IG, Khandwala YS, Kim JH et al (2017) Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015. JAMA 318(16):1561–1568CrossRefPubMedPubMedCentralGoogle Scholar
Peters BS, Armijo PR, Krause C et al (2018) Review of emerging surgical robotic technology. Surg Endosc 32(4):1636–1655CrossRefPubMedGoogle Scholar
Mehaffey JH, Michaels AD, Mullen MG et al (2017) Adoption of robotics in a general surgery residency program: at what cost? J Surg Res 213:269–273CrossRefPubMedGoogle Scholar
Barbash GI, Glied SA (2010) New technology and health care costs—the case of robot-assisted surgery. N Engl J Med 363(8):701–704CrossRefPubMedGoogle Scholar
Farivar BS, Flannagan M, Leitman IM (2015) General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ 72(2):235–242CrossRefPubMedGoogle Scholar
Green CA, Chern H, O’Sullivan PS (2018) Current robotic curricula for surgery residents: a need for additional cognitive and psychomotor focus. Am J Surg 215(2):277–281CrossRefPubMedGoogle Scholar
Schreuder HW, Wolswijk R, Zweemer RP et al (2012) Training and learning robotic surgery, time for a more structured approach: a systematic review. BJOG 119(2):137–149CrossRefPubMedGoogle Scholar
Rashid HH, Leung YY, Rashid MJ et al (2006) Robotic surgical education: a systematic approach to training urology residents to perform robotic-assisted laparoscopic radical prostatectomy. Urology 68(1):75–79CrossRefPubMedGoogle Scholar
Tam V, Lutfi W, Novak S et al (2018) Resident attitudes and compliance towards robotic surgical training. Am J Surg 215(2):282–287CrossRefPubMedGoogle Scholar
Tanaka A, Graddy C, Simpson K et al (2016) Robotic surgery simulation validity and usability comparative analysis. Surg Endosc 30(9):3720–3729CrossRefPubMedGoogle Scholar
Foell K, Furse A, Honey RJ et al (2013) Multidisciplinary validation study of the da Vinci Skills Simulator: educational tool and assessment device. J Robot Surg 7(4):365–369CrossRefPubMedGoogle Scholar
Rehman S, Raza SJ, Stegemann AP et al (2013) Simulation-based robot-assisted surgical training: a health economic evaluation. Int J Surg 11(9):841–846CrossRefPubMedGoogle Scholar
Schaffer AC, Jena AB, Seabury SA et al (2017) Rates and characteristics of paid malpractice claims among US physicians by specialty, 1992–2014. JAMA Intern Med 177(5):710–718CrossRefPubMedPubMedCentralGoogle Scholar
Jin LX, Ibrahim AM, Newman NA et al (2011) Robotic surgery claims on United States hospital websites. J Healthc Qual 33(6):48–52CrossRefPubMedGoogle Scholar
Cooper MA, Ibrahim A, Lyu H et al (2015) Underreporting of robotic surgery complications. J Healthc Qual 37(2):133–138CrossRefPubMedGoogle Scholar
Prewitt R, Bochkarev V, McBride CL et al (2008) The pattern and costs of the Da Vinci surgery system in a large academic institution. J Robot Surg 2(1):17–20CrossRefPubMedGoogle Scholar
Curet MJ, Curet M, Solomon H et al (2009) Comparison of hospital charges between robotic, laparoscopic stapled, and laparoscopic handsewn Roux-en-Y gastric bypass. J Robot Surg 3(2):75–78CrossRefPubMedGoogle Scholar
Yu HY, Hevelone ND, Lipsitz SR et al (2012) Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol 187(4):1392–1398CrossRefPubMedGoogle Scholar
Cook DA, Andersen DK, Combes JR et al (2018) The value proposition of simulation-based education. Surgery 163(4):944–949CrossRefPubMedGoogle Scholar