Pd58-02 Robotic Surgery Skill Transference Between Multi-port (mp) and Single-port (sp) Robotic Platforms
Year: 2021
Type: article
Abstract: INTRODUCTION AND OBJECTIVE: In March 2020, elective surgical procedures in the US were postponed due to the COVID-19 pandemic.The potential degradation of surgical skills during this hiatus has not yet been studied.Our previous work demonstrated that suturing performance is associated with urinary continence recovery after robotic prostatectomy.Herein, we use objective virtual reality (VR) simulation metrics to evaluate suturing technical skill degradation during the COVID-19 shutdown.METHODS: Surgeons completed a robotic VR suturing sponge exercise immediately prior to and after a mandated six-week surgical hiatus that ran from March 20, 2020 to May 5, 2020 at our institution.VR simulator metrics were collected including completion time, economy of motion, instrument collisions, needle drops, and missed targets.Comparisons of parameters before/after the shutdown were performed with either paired Student's t test or Wilcoxon-matched signed rank test.RESULTS: 22 urologic surgeons completed VR sessions preand post-COVID-19 shutdown.Surgeons were classified a priori as novice (<10 cases, n[6), training (10-300 cases, n[7), or expert (>300 cases, n[9) surgeons.Among all participants, weekly robotic surgery caseload decreased from median (IQR) 2.75 (0.5-6.0) pre-COVID to 0.75 (0-1.5)during the shutdown (p<0.001).Overall, we saw an increase in exercise completion time (p<0.001) and missed targets (p[0.004) as well as worse economy of motion (p[0.002) after the shutdown (Figure 1a, 2a, 3a).Our expert cohort had a significant increase in instrument collisions events (p[0.022) and missed targets (p[0.022)(Figure 3b) with significantly fewer needle drops (p[0.025).Our training surgeons had an increase in exercise completion time (p[0.020)and worse economy of motion (p[0.026) while our novice surgeons only showed worse economy of motion (p[0.037)(Figure 1c, 2c, 2d, respectively).CONCLUSIONS: In just six weeks, we saw degradations in measures of efficiency and accuracy for our overall cohort.The observed degradation of technical skill warrants investigation of impacts on clinical outcomes as well as development of methods of retaining surgical skills during common periods of inactivity (sabbatical, maternity/paternity leave).
Source: The Journal of Urology
Authors: Rachel Melnyk, Patrick Saba, Michael Witthaus, Tyler Holler, Beilei Xu, Wencheng Wu, Alexis Steinmetz, Kit Yuen, Karen Doersch, Elizabeth Ellis, Mahmoud Khalil, Jacob Gantz, William Tabayoyong, Jonathan Bloom, Hani Rashid, Nicholas Kavoussi, Ahmed Ghazi
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: National Institutes of Health
OpenAlex ID: W3191678203