Transoral Robotic Surgery

Abstract

Simulation-based standardized training is important for the clinical training of physicians practicing robotic surgery. To train robotic surgery-naïve student volunteers using the da Vinci Skills Simulator (dVSS) for transoral robotic surgery (TORS). Prospective inception cohort in 2012. Academic referral center. Sixteen medical student volunteers lacking experience in robotic surgery. Participants trained with the dVSS in 12 exercises until competent, defined as an overall score of at least 91%. After a 1-, 3-, 5-, or 7-week postinitial training hiatus (n = 4 per group), participants reachieved competence on follow-up. Total training time (TTT) to achieve competency, total follow-up time (TFT) to reachieve competency, and performance metrics. All participants became competent. The TTT distribution was normal based on the Anderson-Darling normality test (P > .50), but our sample was divided into a short training time (STT) group (n = 10 [63%]) and long training time (LTT) group (n = 6 [37%]). The mean (SD) TTT was 2.4 (0.6) hours for the STT group and 4.7 (0.5) hours for the LTT group. All participants reachieved competence with a mean TFT that was significantly shorter than TTT. There was no significant difference between STT and LTT in mean TFT at 1 and 3 weeks (P = .79), but the LTT group had a longer TFT at 5 and 7 weeks (P = .04) but with no difference in final follow-up scores (P = .12). Physicians in training can acquire robotic surgery competency. Participants who acquire skills faster regain robotic skills faster after a training hiatus, but, on retraining, all participants can regain equivalent competence. This information provides a benchmark for a simulator training program.