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Remote teaching system for robotic surgery and its validation: results of a randomized controlled study

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Abstract

Background

Currently, only a limited number of remote assistance modalities are utilized in the basic phase of robotic surgery training to facilitate the rapid acquisition of robotic surgery skills by surgeons. This study aimed to investigate the benefits of real-time remote surgical robotic skill training based on a multi-channel video recording and playback system.

Methods

We randomly divided 40 medical students without prior expertise in the use of surgical robots into two groups to assess the performance of trainees on a robotic simulator (Mimic dV-Trainer). The remote group received remote training, while the control group received live one-on-one guidance. We compared the learning curves of the two groups based on simulator scores. Furthermore, the NASA task load index (NASA-TLX) scale was used to measure the fatigue load of the trainers.

Results

We observed no significant differences in the demographics or initial baseline skill levels between the two groups. Participants in the remote group achieved higher total scores in the Match Board 2 and Thread the Rings 1 exercises compared to the control group. In addition, trainers in the remote group reported lower subjective fatigue load than in the control group.

Conclusions

The remote approach to surgical robotics skills training based on the Remote Teaching System for Robotic Surgery (ReTeRoS) is both feasible and has the potential for large-scale training.

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Acknowledgements

The authors would like to thank all the volunteers who participated in this study for their kind support.

Funding

This study was supported by Zhongnan Hospital of Wuhan University Science, Technology and Innovation Seed Fund. The title of our funded project was “Project Stereo vision-based determination and characterization of surgical robot operator trajectory” (Grant No. znpy2019003); Provincial Teaching Research Projects in Hubei Universities (dated 2022013).

Author information

Author notes

  1. Lingxiao Jiang and Gaojie Chen have contributed equally to this work and share the role of the first author.

Authors and Affiliations

  1. Second Clinical College, Hospital of Wuhan University, Wuhan, Hubei, China

    Lingxiao Jiang, Gaojie Chen, Lu Li, Ziyan Chen, Kun Yang & Xinghuan Wang

  2. Medicine - Remote Mapping Associated Laboratory, ZhongNan Hospital, Wuhan University, Wuhan, Hubei, China

    Lingxiao Jiang, Gaojie Chen, Lu Li, Ziyan Chen & Kun Yang

  3. Department of Urology, Zhongnan Hospital, Wuhan University, No. 169 Donghu Road, 430071, Wuhan, Hubei, China

    Kun Yang & Xinghuan Wang

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  1. Lingxiao Jiang
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Corresponding authors

Correspondence to Kun Yang or Xinghuan Wang.

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Disclosures

Lingxiao Jiang, Gaojie Chen, Lu Li, Ziyan Chen, Kun Yang, and Xinghuan Wang have no conflicts of interest or financial ties to disclose.

Ethical approval

The study was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (ID: 2023074k) and was registered at ChiCTR (ID: ChiCTR2300071027).

Informed consent

All participants were provided with detailed information about the study and signed an informed consent form in writing.

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Supplementary Information

Below is the link to the electronic supplementary material.

464_2023_10443_MOESM1_ESM.tif

Supplementary file1 (TIF 267 KB) Supplementary Figure 1. The sensor emits a horizontal detection line. When the front arm blocks the detection line on the armrest, the sensor does not sound a warning tone. When the front arm is lifted off the armrest, the detection line is not blocked by the forearm. The sensor can emit a “left or right hand” warning tone, indicating that the forearm has too much range of motion

464_2023_10443_MOESM2_ESM.tif

Supplementary file2 (TIF 574 KB) Supplementary Figure 2. Through OBS, multi-channel video sources are collected and the operation is displayed to the remote end using the Tencent Meeting shared screen. All participants can interact with the voice by connecting to a Bluetooth headset

464_2023_10443_MOESM3_ESM.tif

Supplementary file3 (TIF 208 KB) Supplementary Figure 3. The effect of training order on the results of PB2: The left graph shows the results of comparing the overall score of the first three and the last three in the control group, and the right graph shows the results of comparing the overall score of the first three and the last three in the remote group

464_2023_10443_MOESM4_ESM.tif

Supplementary file4 (TIF 250 KB) Supplementary Figure 4. The effect of training order on the results of MB2: The left graph shows the results of comparing the overall score of the first three and the last three in the control group, and the right graph shows the results of comparing the overall score of the first three and the last three in the remote group

464_2023_10443_MOESM5_ESM.tif

Supplementary file5 (TIF 1609 KB) Supplementary Figure 5. (a):Trainer instruction at the remote side; (b):Route Planning; (c):Remind the angle of the clamping and release; (d):Remind the trainees to adjust their foot placement; (e): Reminded of the improper force which caused the instrument to turn red; (f):Reminder of improper needle holding position and needle feeding angle

Supplementary file6 (DOCX 26 KB)

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Jiang, L., Chen, G., Li, L. et al. Remote teaching system for robotic surgery and its validation: results of a randomized controlled study. Surg Endosc 37, 9190–9200 (2023). https://doi.org/10.1007/s00464-023-10443-w

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