Shortening surgical training through robotics: randomized clinical trial of laparoscopicversusrobotic surgical learning curves

Background Minimally invasive surgery is the standard technique for many operations. Laparoscopic training has a long learning curve. Robotic solutions may shorten the training pathway. The aim of this study was to compare laparoscopic with robotic training in surgical trainees and medical students. Methods Surgical trainees (ST group) were randomized to receive 6 h of robotic or laparoscopic simulation training. They then performed three surgical tasks in cadaveric specimens. Medical students (MS group) had 2 h of robotic or laparoscopic simulation training followed by one surgical task. The Global Rating Scale (GRS) score (maximum 30), number of suture errors, and time to complete each procedure were recorded. Results The median GRS score for the ST group was better for each procedure after robotic training compared with laparoscopic training (total GRS score: 27 center dot 00 (i.q.r. 22 center dot 25-28 center dot 33)versus18 center dot 00 (16 center dot 50-19 center dot 04) respectively,P < 0 center dot 001; 10 participants in each arm). The ST group made fewer errors in robotic than in laparoscopic tasks, for both continuous (7 center dot 00 (4 center dot 75-9 center dot 63)versus22 center dot 25 (20 center dot 75-25 center dot 25);P < 0 center dot 001) and interrupted (8 center dot 25 (6 center dot 38-10 center dot 13)versus29 center dot 50 (23 center dot 75-31 center dot 50);P < 0 center dot 001) sutures. For the MS group, the robotic group completed 8 center dot 67 interrupted sutures with 15 center dot 50 errors in 40 min, compared with only 3 center dot 50 sutures with 40 center dot 00 errors in the laparoscopic group (P < 0 center dot 001) (10 participants in each arm). Fatigue and physical comfort levels were better after robotic compared with laparoscopic operating for both groups (P < 0 center dot 001). Conclusion The acquisition of surgical skills in surgical trainees and the surgically naive takes less time with a robotic compared with a laparoscopic platform.