Remote Surgical Training (ReST): The Road to a Fully-fledged Remote Robotic Surgery

Abstract

Introduction: Remote control of surgical robots represents a valuable opportunity for computer-assisted surgery. Since signal latency is still not yet compatible with safe clinical practice, we explored a field of application that is free from patient-safety issues, namely training. Our research aims to demonstrate the feasibility and effectiveness of Remote Surgical Training (ReST) in the cadaver lab or on alternative models. Methods: ReST tests were carried out over a short distance, using the Xi da Vinci dual console and a cable connection. A trainee performed surgical tasks assisted by a trainer, and a tutor was dislocated remotely in an adjacent OR. ReST tests were compared with control events with tutors and trainees in the same robotic OR. Trainee’s performance was evaluated by supervisors using the Global Evaluative Assessment of Robotic Skills (GEARS) score. At the end of each event, all subjects filled in an online Likert scale-based questionnaire to evaluate the educational process. Results: Fifteen ReST tests were successfully completed and compared with fifteen control events. Statistical analysis of questionnaire data showed no significant differences in the educational process between the ReST group and the control group. At GEARS assessment, trainees achieved similar mean performance scores in both groups. Conclusion: Remote surgical training appears to be feasible and effective. Our results support further investigation on more advanced forms of remote training, including remotely displacing the trainee and testing by cable or wireless network connection over a long distance. This research is the first step towards remote robotic surgery.