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Can remote assistance for robotic surgery improve surgical performance in simulation training? A prospective clinical trial of urology residents using a simulator in south america.
Carneiro, Arie; Claros, Oliver Rojas; Cha, Jonathan Doyun; Kayano, Paulo Priante; Apezzato, Marcelo; Wagner, Andrew Aurel; Lemos, Gustavo Caserta.
Afiliación
  • Carneiro A; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
  • Claros OR; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
  • Cha JD; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
  • Kayano PP; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
  • Apezzato M; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
  • Wagner AA; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
  • Lemos GC; Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Int Braz J Urol ; 48(6): 952-960, 2022.
Article en En | MEDLINE | ID: mdl-36173407
INTRODUCTION: We aimed to evaluate the role of remote proctoring during the initial training phases of a robotics curriculum using surgical robot skills simulator exercises. MATERIALS AND METHODS: Prospective randomized study comprising 36 urology residents and junior staff urologists without previous robotic training. Group 1 (G1) performed exercises without any assistance or support, group 2 (G2) received support from in-person proctor, and group 3 (G3) from a remote proctor through a telementoring system. Qualitative and quantitative analyses were conducted for each exercise and group. RESULTS: The overall score approval rates (OSA) for the different skill exercises were Ring Walk 2 (RW2) 83%, Energy Dissection 2 (ED2) 81%, and Ring Walk 3 (RW3) 14%. RW2 OSA was higher on attempt 3 than on attempt 1 (83.3% vs. 63.9%, p=0.032). ED2 OSA rate was higher in attempt 3 than in attempt 1 (80.6% vs. 52.8%, p=0.002). RW2 OSA was similar among the groups. In ED2, both remote and live assistance were significantly related to upper OSA (G1=47.2%, G2=75.0%, G3=83.3%, p=0.002). RW3 had similar OSA among the groups, which can be explained by the high level of difficulty and low OSA in all the groups. However, in a sensitive quantitative analysis, the mean overall score of the participants in RW3 was higher in both proctored groups (G1=24, G2=57.5, G3=51.5, p=0.042). CONCLUSION: Robotic performance increased significantly over three attempts for simulation exercises of low, medium, but not high-complexity. Proctoring, either in-person or remotely, has a positive impact on approval performance, particularly in intermediate tasks.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Urología / Procedimientos Quirúrgicos Robotizados / Entrenamiento Simulado Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Int Braz J Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Brasil

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Urología / Procedimientos Quirúrgicos Robotizados / Entrenamiento Simulado Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Int Braz J Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Brasil