Abstract
The da Vinci (Intuitive Surgical, Inc., Sunnyvale, CA) surgical system is being used by an increasing number of surgeons across several surgical specialties. The robotic interface is different not only to open surgery, but also to laparoscopy because it involves remote surgical control, stereoscopic vision, and lack of haptic feedback. As the transition is made from traditional open to robotic surgery, factors such as learning of robotic skills, assessment of pro.ciency in robotics, and structured training for urologists in practice and residents assumes importance. Understanding how the robotic surgical technique is learned and how such learning can be best assessed will enable us to de.ne protocols for training and set standards for pro.ciency. Learning curve and surgical dexterity are two parameters that are used to compare surgical learning and training. This article presents the current gold standard for assessing skill training and compares surgical skill acquisition and pro.ciency using conventional laparoscopy and robotic interfaces.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References and Recommended Reading
Sanjeev K, Menon M: Robotics in laparoscopic urology. Min Invasive Ther 2005, 14:62–70. An extensive review of the current role of robotics in urology, including techniques of robotic-assisted urologic procedures and outcomes published in literature.
McLeod IK, Mair EA, Melder PC: Potential applications of the da Vinci minimally invasive surgical robotic system in otolaryngology. Ear Nose Throat J 2005, 84:483–487.
Kariv Y, Delaney CP: Robotics in colorectal surgery. Minerva Chir 2005, 60:401–416.
Bonatti J, Schachner T, Bonaros N, et al.: Ongoing procedure development in robotically assisted totally endoscopic coronary artery bypass grafting (TECAB). Heart Surg Forum 2005, 8:287–291.
Di Lorenzo N, Coscarella G, Faraci L, et al.: Robotic systems and surgical education. JSLS 2005, 9:3–12.
Bollens R, Sandhu S, Roumeguere T, et al.: Laparoscopic radical prostatectomy: the learning curve. Curr Opin Urol 2005, 15:79–82.
Hernandez J, Bann S, Munz K, et al.: Qualitative and quantitative analysis of the learning curve of a simulated task on the da Vinci system. Surg Endosc 2004, 18:372–378. A very succinct paper explaining current gold standard in assessing surgical dexterity.
Herrell SD, Smith JA Jr: Robotic-assisted laparoscopic prostatectomy: What is the learning curve? Urology 2005, 66:105–107.
Frede T, Erdogru T, Zukosky D, et al.: Comparison of training modalities for performing laparoscopic radical prostatectomy: experience with 1000 patients. J Urol 2005, 174:673–678.
Poulakis V, Dillenberg W, Moeckel M, et al.: Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. Eur Urol 2005, 2:167–175.
Watson D, Baigrie R, Jamieson G: A learning curve for laparoscopic fundoplication: de.nable, avoidable, or a waste of time. Ann Surg 1996, 224:198–203.
Maniar H, Council M, Prasad S, et al.: Comparison of skill training with robotic systems and traditional endoscopy: implications on training and adoption. J Surg Res 2005, 125:23–29. A very thorough comparison of learning curve using conventional laparoscopy and robotic interface.
Korndorffer J, Dunne B, Sierra R, et al.: Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 2005, 201:23–29.
Moorthy K, Munz Y, Dosis J, et al.: Dexterity enhancement with robotic surgery. Surg Endosc 2004, 18:790–795.
Darzi A, Smith S, Taf.nder N: Assessing operative skill. Br Med J 1999, 318:887–888.
Ramsay C, Grant A, Wallace S, et al.: Assessment of learning curve in health technologies. Int J Technol Assess Health Care 2000, 16:1095–1108.
Datta V, Mackay S, Mandalia M, Darzi A: The use of electromagnetic motion tracking analysis to objectively measure open surgical skill in the laboratory based model. J Am Coll Surg 2001, 193:479–485.
Martin J, Regehr G, Reznick R, et al.: Objective structured assessment of technical skills (OSATS) for surgical residents. Br J Surg 1997, 84:273–278. This paper explains the current gold standard for assessing learning curve and details future developments in technology for assessing learning in surgery.
Sarle R, Tewari A, Shrivastava A, et al.: Surgical robotics and laparoscopic training drills. J Endourol 2004, 18:63–66.
Garcia-Ruiz A, Gagner M, Miller J, et al.: Manual versus robotic assisted laparoscopic surgery in the performance of basic manipulation and suturing tasks. Arch Surg 1998, 133:957–961.
Yohannes P, Rotariu P, Pinto P, et al.: Comparison of robotic versus laparoscopic skills: Is there a difference in the learning curve? Urology 2002, 60:39–45.
Prasad S, Prasad S, Maniar C, et al.: Surgical robotics: impact of motion scaling on task performance. J Am Coll Surg 2004, 199:863.
Obek C, Hubka M, Porter M, et al.: Robotic versus conventional laparoscopic skill acquisition: implications for training. J Endourol 2005, 19:1098–1103.
Nio D, Balm R, Maartense S, et al.: The ef.cacy of robotassisted versus conventional laparoscopic vascular anastomoses in an experimental model. Eur J Vasc Endovasc Surg 2004, 27:283–286.
Sung GT, Gill IS: Robotic laparoscopic surgery: a comparison of the Da Vinci and Zeus systems. Urology 2001, 58:893–898.
Jourdan I, Dutson A, Garcia T, et al.: Stereoscopic vision provides a signi.cant advantage for precision robotic surgery. Br J Surg 2004, 91:879–885.
Hanna G, Drew T, Clinch P, et al.: Psychomotor skills for endoscopic manipulations: differing abilities between right- and left-handed individuals. Ann Surg 1997, 225:333.
Ahlering TE, Skarecky D, Lee D, Clayman RV: Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 2003, 170:1738–1741.
Patel V, Tully A, Holmes R, Lindsay J: Robotic radical prostatectomy in the community setting. Learning curve and beyond: initial 200 cases. J Urol 2005, 174:269–272.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kaul, S., Shah, N.L. & Menon, M. Learning curve using robotic surgery. Curr Urol Rep 7, 125–129 (2006). https://doi.org/10.1007/s11934-006-0071-4
Issue Date:
DOI: https://doi.org/10.1007/s11934-006-0071-4