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

Autor: Arie Carneiro, Oliver Rojas Claros, Jonathan Doyun Cha, Paulo Priante Kayano, Marcelo Apezzato, Andrew Aurel Wagner, Gustavo Caserta Lemos
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Brazilian Journal of Urology, Vol 48, Iss 6, Pp 952-960 (2022)
Druh dokumentu: article
ISSN: 1677-6119
1677-5538
DOI: 10.1590/s1677-5538.ibju.2022.0104
Popis: ABSTRACT 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.
Databáze: Directory of Open Access Journals
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