Abstrakt Technologie Březen 2009

“Validation of a novel virtual reality robotic simulator.”

Sethi, A. S., W. J. Peine, et al. (2009).

J Endourol 23(3): 503-8.


PURPOSE: We evaluated the face, content, and construct validity of what is, to our knowledge, the only available virtual reality simulator based on a complete kinematic representation of the da Vinci surgical system. MATERIALS AND METHODS: A total of 5 experts (EPs) and 15 novices (NVs) completed exercises on the Mimic dV-Trainer (MdVT). All participants completed three repetitions of the following tasks: (1) Ring and Cone, (2) String Walk, and (3) Letterboard. Participants rated parameters of face and content validity on a five-point Likert-scale questionnaire. Workload imposed by the simulator was assessed using a NASA Task Load Index questionnaire (TLX). RESULTS: Face validity of the MdVT was established as all 20 participants rated the simulator between average to easy-to-use and above-average to high in all parameters of realism. Participants in both EP and NV groups rated the MdVT’s overall relevance to robotic surgery as very high. All five EPs assessed the simulator to be a very good practice format and very useful for training residents, thereby affirming content validity. A preliminary assessment of construct validity suggested that the MdVT could differentiate EPs from NVs. The overall TLX workload scores were lower in the EP group for all parameters except for temporal demand. CONCLUSIONS: The MdVT demonstrated excellent face and content validity as well as reasonable workload parameters. The use of this simulator in resident training may help bridge the gap between the safe acquisition of surgical skills and effective performance during live robot-assisted surgery.


“Performance of basic manipulation and intracorporeal suturing tasks in a robotic surgical system: single- versus dual-monitor views.”

Shah, R. D., A. Cao, et al. (2009).

Surg Endosc 23(4): 727-33.

BACKGROUND: Technical advances in the application of laparoscopic and robotic surgical systems have improved platform usability. The authors hypothesized that using two monitors instead of one would lead to faster performance with fewer errors. METHODS: All tasks were performed using a surgical robot in a training box. One of the monitors was a standard camera with two preset zoom levels (zoomed in and zoomed out, single-monitor condition). The second monitor provided a static panoramic view of the whole surgical field. The standard camera was static at the zoomed-in level for the dual-monitor condition of the study. The study had two groups of participants: 4 surgeons proficient in both robotic and advanced laparoscopic skills and 10 lay persons (nonsurgeons) who were given adequate time to train and familiarize themselves with the equipment. Running a 50-cm rope was the basic task. Advanced tasks included running a suture through predetermined points and intracorporeal knot tying with 3-0 silk. Trial completion times and errors, categorized into three groups (orientation, precision, and task), were recorded. RESULTS: The trial completion times for all the tasks, basic and advanced, in the two groups were not significantly different. Fewer orientation errors occurred in the nonsurgeon group during knot tying (p=0.03) and in both groups during suturing (p=0.0002) in the dual-monitor arm of the study. Differences in precision and task error were not significant. CONCLUSIONS: Using two camera views helps both surgeons and lay persons perform complex tasks with fewer errors. These results may be due to better awareness of the surgical field with regard to the location of the instruments, leading to better field orientation. This display setup has potential for use in complex minimally invasive surgeries such as esophagectomy and gastric bypass. This technique also would be applicable to open microsurgery.