Laparoscopic and Robotic Skills Are Transferable in a Simulation Setting: A Randomized Controlled Trial

Abstract

BACKGROUND: Residents are increasingly being trained on robotic techniques instead of traditional laparoscopy. Although simulation training does provide an effective supplement for traditional surgical training, less is known if skills are transferable between the laparoscopic and robotic platforms. METHODS: In a randomized single-blinded controlled trial of 40 simulation-skill-naive medical students, participants completed a baseline evaluation on a robotic pegboard-transfer task (Mimic dV-Trainer) and laparoscopic peg-transfer task (Fundamentals of Laparoscopic Surgery). Skills were evaluated using validated objective and subjective global rating scales (GRS) by two blinded expert surgeons. Participants were randomized to practice on either the robotic (N=20) or laparoscopic (N=20) task. After practice, participants were reevaluated performing both tasks. RESULTS: At baseline, there were no significant differences in objective measures (time to task completion, motion metrics) or composite GRS scores on both tasks between the groups. Participants performed their respective tasks faster (P<.001, P<.003), more efficiently (P<.001) and with a higher percent improvement in composite GRS scores (P<.001). The laparoscopic group improved their robotic performance with an increase in mean composite GRS scores of 15–20 but this change did not reach statistical significance (P=.091). Participants who practiced robotically significantly improved their laparoscopic performance with an increase in mean composite GRS scores of 15–19 (P<.02). DISCUSSION: Skills learned on either the robotic or laparoscopic platform appear to be transferable; however, robotic skills appear to be more transferable to the laparoscopic platform, than vice versa.