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Neri A, Coduri M, Penza V, Santangelo A, Oliveri A, Turco E, Pizzirani M, Trinceri E, Soriero D, Boero F, Ricci S, Mattos LS. A novel affordable user interface for robotic surgery training: design, development and usability study. Front Digit Health 2024; 6:1428534. [PMID: 39139587 PMCID: PMC11319275 DOI: 10.3389/fdgth.2024.1428534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction The use of robotic systems in the surgical domain has become groundbreaking for patients and surgeons in the last decades. While the annual number of robotic surgical procedures continues to increase rapidly, it is essential to provide the surgeon with innovative training courses along with the standard specialization path. To this end, simulators play a fundamental role. Currently, the high cost of the leading VR simulators limits their accessibility to educational institutions. The challenge lies in balancing high-fidelity simulation with cost-effectiveness; however, few cost-effective options exist for robotic surgery training. Methods This paper proposes the design, development and user-centered usability study of an affordable user interface to control a surgical robot simulator. It consists of a cart equipped with two haptic interfaces, a VR visor and two pedals. The simulations were created using Unity, which offers versatility for expanding the simulator to more complex scenes. An intuitive teleoperation control of the simulated robotic instruments is achieved through a high-level control strategy. Results and Discussion Its affordability and resemblance to real surgeon consoles make it ideal for implementing robotic surgery training programs in medical schools, enhancing accessibility to a broader audience. This is demonstrated by the results of an usability study involving expert surgeons who use surgical robots regularly, expert surgeons without robotic surgery experience, and a control group. The results of the study, which was based on a traditional Peg-board exercise and Camera Control task, demonstrate the simulator's high usability and intuitive control across diverse user groups, including those with limited experience. This offers evidence that this affordable system is a promising solution for expanding robotic surgery training.
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Affiliation(s)
- Alberto Neri
- Biomedical Robotics Lab, Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Computer Science, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genova, Italy
| | - Mara Coduri
- Department of Computer Science, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genova, Italy
- Simulation and Advanced Education Center, University of Genova, Genova, Italy
| | - Veronica Penza
- Biomedical Robotics Lab, Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Andrea Santangelo
- Biomedical Robotics Lab, Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Alessandra Oliveri
- Department of Computer Science, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genova, Italy
| | - Enrico Turco
- Humanoid and Human Centred Mechatronics (HHCM), Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | | | | | - Domenico Soriero
- Unit of Surgical Oncology, IRCCS Policlinico San Martino, Genoa, Italy
| | | | - Serena Ricci
- Department of Computer Science, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genova, Italy
- Simulation and Advanced Education Center, University of Genova, Genova, Italy
| | - Leonardo S. Mattos
- Biomedical Robotics Lab, Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
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Identifying technical skills and clinical procedures in surgery for a simulation-based curriculum: a national general needs assessment. Surg Endosc 2021; 36:47-56. [PMID: 33398569 DOI: 10.1007/s00464-020-08235-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The efficacy of simulation-based training in surgical education is well known. However, the development of training programs should start with problem identification and a general needs assessment to ensure that the content is aligned with current surgical trainee needs. The objective of the present study is to identify the technical skills and clinical procedures that should be included in a simulation-based curriculum in general surgery. METHODS A national, three-round Delphi process was conducted to achieve consensus on which technical skills and clinical procedures should be included in a simulation-based curriculum in general surgery. In total, 87 key opinion leaders were identified and invited to the study. RESULTS Round 1 of the Delphi process had a response rate of 64% (56/87) and a total of 245 suggestions. Based on these suggestions, a consolidated list of 51 technical skills or clinical procedures was made. The response rate in Delphi round 2 was 62% (54/87) resulting in a pre-prioritized order of procedures for round 3. The response rate in Delphi round 3 was 65% (35/54). The final list included 13 technical skills and clinical procedures. Training was predominantly requested within general open surgical skills, laparoscopic skills, and endoscopic skills, and a few specific procedures such as appendectomy and cholecystectomy were included in the final prioritized list. CONCLUSION Based on the Delphi process 13 technical skills and clinical procedures were included in the final prioritized list, which can serve as a point of departure when developing simulation-based training in surgery.
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Anton NE, Gardner AK, Stefanidis D. Priorities in surgical simulation research: What do the experts say? Am J Surg 2019; 220:95-99. [PMID: 31672307 DOI: 10.1016/j.amjsurg.2019.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Progressing the field of surgical simulation research cohesively requires organization. The purpose of this study was to establish contemporary research priorities utilizing Delphi methodology. METHODS Surgical researchers with expertise in simulation-based research were invited to submit important questions for the field according to an organized framework. Thematic analysis was used to collapse questions into unique questions. In a second round, experts rated the importance of questions. In a third round, experts re-rated the importance of questions. A prioritized agenda was then created. RESULTS Eighteen experts submitted 80 questions in round one, which were collapsed into 43. In the final round, experts rated the following question as the most important priority: "Does demonstrated competency in the simulation lab translate to clinical competency (OR etc.)?" CONCLUSIONS Our systematic approach identified multiple important questions to advance the field that may guide researchers and funding agencies alike.
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Affiliation(s)
- Nicholas E Anton
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Dimitrios Stefanidis
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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Anton NE, Mizota T, Timsina LR, Whiteside JA, Myers EM, Stefanidis D. Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment. Am J Surg 2018; 217:266-271. [PMID: 30538032 DOI: 10.1016/j.amjsurg.2018.11.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/31/2018] [Accepted: 11/19/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. METHODS Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression. RESULTS Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test. CONCLUSIONS Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
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Affiliation(s)
- Nicholas E Anton
- Department of Surgery, Indiana University School of Medicine, USA
| | - Tomoko Mizota
- Department of Surgery, Indiana University School of Medicine, USA
| | - Lava R Timsina
- Department of Surgery, Indiana University School of Medicine, USA
| | - Jake A Whiteside
- Department of Surgery, Indiana University School of Medicine, USA
| | - Erinn M Myers
- Carolinas Simulation Center, Carolinas Healthcare System, USA
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