857 EFFECT OF DISTRACTION ON ROBOTIC SURGICAL SKILLS PERFORMANCE IN DIFFERENT LEVELS OF SURGICAL EXPERIENCE

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy I1 Apr 2012857 EFFECT OF DISTRACTION ON ROBOTIC SURGICAL SKILLS PERFORMANCE IN DIFFERENT LEVELS OF SURGICAL EXPERIENCE Irene Suh, Kevin Clay, Chad LaGrange, Dmitry Oleynikov, and Ka-Chun Siu Irene SuhIrene Suh Omaha, NE More articles by this author , Kevin ClayKevin Clay Omaha, NE More articles by this author , Chad LaGrangeChad LaGrange Omaha, NE More articles by this author , Dmitry OleynikovDmitry Oleynikov Omaha, NE More articles by this author , and Ka-Chun SiuKa-Chun Siu Omaha, NE More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.950AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Operating rooms are full of distractions, which can cause impaired surgical performance and impact patient safety. Little is known whether the effects of distraction on robotic surgical performance are varied based on the level of surgical experience. Objective: Investigate the effects of distraction on robotic surgical skills performance and compare such effect among different levels of surgical experience. METHODS Ten medical students (novice), one fellow in general surgery (robot-naive) and two urological residents (robot-experienced) performed a knot-tying task using the DaVinciTM Surgical System. Subjects were exposed to three distractions: passive, active and interactive. Passive distraction entailed listening to noise (50-90dB) with an audible constant heart rate. Active distraction included listening to noise, however the heart rate changed randomly from 60 to 120 bpm and subjects had to acknowledge the change. Interactive distraction consisted of answering continuous math questions (adding or subtracting between two double digit numbers). The time to task completion (TTC) and the average speed (SPD) of the surgical instrument tips were used to evaluate the performance of knot-tying. The performance was also scored using the objective fundamentals of laparoscopic surgery guidelines. Two-way repeated-measures ANOVA were applied to examine the effects of distraction and the level of surgical experience on skills performance. RESULTS A significant distraction effect was found for both the TTC (p = 0.009) and the SPD (p < 0.010). The follow-up comparisons indicated that interactive distraction increased TTC and showed larger negative impact than active (p = 0.024) and passive (p = 0.022) distractions. A significant level of experience effect was found for the SPD (p < 0.001). Robot-experienced residents significantly moved faster than robot-naïve (p = 0.027), and novice (p < 0.001) in the first three trials. Suturing score in novice was significantly lower (p = 0.021) than both other groups. There were no significant differences between the robot-experienced subjects and robot-naïve in the knot-tying score. CONCLUSIONS Distractions can draw a subject's attention away from the knot-tying task and lead to a poor performance score. It is suggested that robotic surgical skills training in urology should be given in a distractive environment that simulates a typical operating room, which allows new urologists to learn how to filter the distractions while practicing robotic surgical skills. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e350 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Irene Suh Omaha, NE More articles by this author Kevin Clay Omaha, NE More articles by this author Chad LaGrange Omaha, NE More articles by this author Dmitry Oleynikov Omaha, NE More articles by this author Ka-Chun Siu Omaha, NE More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...