An International Perspective on Simulation-Based Training for Robot-Assisted Surgery.

A. Aboumohamed, K. Ahmed, S. Raza, Y. Shi, G. Wilding, I. Aloraifi, T. Kesavadas, A. Chowriappa, J. Peabody, C. Rochat, K. Guru

Roswell Park Cancer Institute; King’s College London; Henry Ford Hospital; Albert Einstein College of Medicine of Yeshiva University

Purpose:
Surgical training is rapidly evolving due to work hour limitations, safety concerns and need for reducing the learning curve. Introduction and adaption of robot-assisted surgery (RAS) during the last decade has accelerated the incorporation of simulation-based learning in view of absent tactile feedback and remote magnified operative field. We sought to evaluate the current opinion of multi-national urologic surgeons regarding the value and current use of simulation-based training (SBT) for RAS.

Material & Methods
An online anonymous quantitative questionnaire was developed and completed between June – August 2012 by urologic surgeons at various levels of training and robotic experience. Survey consisted of Likert scale questions documenting prior experience, opinions and current status of SBT for RAS. The survey evaluated the participants regarding their background, personal experience with surgical simulation, institutional status regarding use of simulation for training in RAS and its value for RAS.

Results
358 urologic surgeons completed the survey of which 127 were training directors/ coordinators, 151 attending surgeons and 80 fellows/ residents; 74.9% had personal experience in RAS and/ or had a robotic surgical system in their institute. 64.4% have never worked on training simulators; meanwhile 54.9% did not have surgical simulators in their institutes. 85.2% believe the SBT should be a mandatory part of their surgical program, and 92% believe there should be dedicated time for SBT for new trainees. 80.2% believe SBT helps in effective transfer of surgical skills to the OR and 82.3% believe it enhances patient safety. Regarding pre-procedure warm-up, 46.8% agreed of its importance (77.3% in regions outside North America and Europe, only 42.7% in North America, and 44.9% in Europe). Overall 51.9% surgeons would prefer their surgeon to perform a warm-up before the actual surgery (41.8% from Europe, 53% North America, and 90.9% from other areas). 76.8% surgeons attributed cost (70.3%), availability (52.2%), and need for elaborate set-up (45%) responsible for not having access to a wet laboratory (Porcine) for training at their institution

Conclusion
Simulated based training has begun to integrate in the robot-assisted surgical training and its use is felt to be helpful in skill acquisition and patient safety in the operating room.


Session: Poster Presentation

Program Number: ETP021

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