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Transfer of skills between laparoscopic and robot-assisted surgery: a systematic review

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Abstract

Background

Robot-assisted surgery is today well-implemented in many surgical specialties, but requires another skill set than laparoscopy. Most often, robot-assisted surgery is considered add-on to laparoscopic skills but very little is known about the transfer of skills. The aim of the study was to examine to what extent surgical skills are transferable between laparoscopic and robot-assisted surgery.

Methods

A systematic search was conducted in three databases (Ovid Medline, Embase, and Web of Science). Studies investigating transfer of skills between laparoscopy and robot-assisted surgery in either a phantom-based, simulation-based, animal model, or clinical setting were eligible for inclusion. Quality assessment was done using the Medical education research study quality instrument and educational New Ottawa Scale.

Results

Of 15,610 studies identified, 89 studies continued to full-text reading, and 37 studies were included. Four studies were found non-comparable and were left out of the results for the primary outcome. All 33 studies explored transfer from laparoscopy to robot-assisted surgery and 17 found a positive transfer whereas 15 did not. Only 11 studies explored transfer from robot-assisted surgery to laparoscopy, of which only three found a positive transfer.

Conclusion

An almost equal number of publications found a positive transfer and no transfer from laparoscopic to robot-assisted surgery. Fewer studies explored the transfer from robot-assisted surgery to laparoscopy. Very little evidence supports that surgeons trained solely in robot-assisted surgery can perform laparoscopy. This must be considered in future training programs as robot-assisted surgery is expected to become the first-in-line modality for many future surgeons.

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Authors and Affiliations

  1. Department of Radiology, Odense University Hospital, Kløvervænget 10, Entrance 112, 2nd floor, 5000, Odense C, Denmark

    Pia Iben Pietersen

  2. Simulation Center (SimC), Odense University Hospital, Odense, Denmark

    Pia Iben Pietersen

  3. Department of Surgery, Hospital Lillebaelt, University of Southern Denmark, Kolding, Denmark

    Peter Hertz

  4. Copenhagen Prostate Cancer Center, Rigshospitalet, Copenhagen, Denmark

    Rikke Groth Olsen

  5. Center for HR & Education, The Capital Region of Denmark, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark

    Rikke Groth Olsen, Louise Birch Møller, Lars Konge & Flemming Bjerrum

  6. University of Copenhagen, Copenhagen, Denmark

    Lars Konge

  7. Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark

    Flemming Bjerrum

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Pia Iben Pietersen, Peter Hertz, Rikke Groth Olsen, Louise Birch Møller, Lars Konge, and Flemming Bjerrum have no conflicts of interest or financial ties to disclose.

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Pietersen, P.I., Hertz, P., Olsen, R.G. et al. Transfer of skills between laparoscopic and robot-assisted surgery: a systematic review. Surg Endosc 37, 9030–9042 (2023). https://doi.org/10.1007/s00464-023-10472-5

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