Robotic4all project: Results of a hands-on robotic surgery training program

Objective: Although robotic surgery adoption and its indications are growing worldwide, for multiple factors, including costs, there is a lack of training and experience. Our aim was to study the impact of a robotic introduction training program on gesture performance, such as suturing, in robot-naive
individuals.
Methods: Using the DaVinci robot, a 2-hour program was based on virtual reality and anatomical model
exercises. All participants performed 3 repetitions of virtual reality exercises on the virtual simulator, and
then performed and were assessed on 2 tests, ie robot and laparoscopic training box. After the course, the
participants were surveyed for this training program.
Results: Twenty-seven residents and surgeons were enrolled in the training program. With only 2 hours
of training, all of the participants were able to complete the training program, thus learning generic and
specific skills in robotic surgery. In virtual reality exercise, the scores of the 3 exercises increased
significantly with every repetition (p < 0.001) and the size of the increase was large. The completion time
on the robot platform was 2.6 times faster (169.33 ± 28.28 s vs. 447.96 ± 156.55 s, p < 0.001) than that in
the laparoscopic box, and the difference between both types of tests was large (p h 2 ¼ 0.797). The
centralization and passage of the needle were significantly better on the robot platform (5 vs. 3,
p < 0.001, r ¼ 0.47; 5 vs. 4, p < 0.001, r ¼ 0.59) than in the laparoscopic box. For the intracorporeal
stitchþknot test, every participant was able to perform the exercise on the robot but only 85.2% (23/27)
in the laparoscopic box. Twenty-one participants answered the survey, and 13 (61.9%) of them consid-
ered robotic performance independent of laparoscopic experience.
Conclusions: Surgeons are interested and seek training in robotic surgery. We implemented the first
hands-on robotic surgery training program in Portugal and participants considered it was important and
adequate for its purpose. All participants, even without robotic experience, learned quicker, performed
better, faster and more precisely on the robot over laparoscopy.
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