Randomized controlled trial of virtual reality and hybrid simulation for robotic surgical training

OBJECTIVE To evaluate if two commonly used laparoscopic simulators could be adapted and used successfully for the robotics platform in a laparoscopic and roboticnaive medical student population. MATERIALS AND METHODS We identified two widely validated laparoscopic simulation programs, LapSim (R) (Surgical Science Sweden AB), and ProMIS (R) (Haptica, Ireland) for inclusion in the study. The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (R) task set was used for ProMIS, and adapted for the DaVinci (R) console (Intuitive Surgical, Inc., Sunnyvale, CA, USA) robotic platform. We then randomized 20 naive medical students to receive training on either LapSimor ProMIS, both or neither, and evaluated them beforeand aftertraining. RESULTS When the groups were compared at baseline, there were no statistical differences in mean scores amongst the groups in univariate analysis (alpha = 0.05). Whencomparing mean scores within groups before and after training sessions, statistically significant performance enhancement in all four robotic tasks were identified in the groups receiving dual training. CONCLUSION We have shownthat the use of ProMIS hybrid and LapSimvirtual reality (VR) simulators in conjunction with each other can considerable improve robotic console performance in novice medical students compared with hybrid and VR simulation alone.