Virtual reality suturing task as an objective test for robotic experience assessment

Background: We performed a pilot study using a single virtual-simulation suturing module as an objective measurement to determine functional use of the robotic system. This study will assist in designing a study for an objective, adjunctive test for use by a surgical proctor. Methods: After IRB approval, subjects were recruited at a robotic renal surgery course to perform two attempts of the "Tubes" module without warm-up using the Da Vinci® Surgical Skills Simulator™. The overall MScore (%) from the simulator was compared among various skill levels to provide construct validity. Correlation with MScore and number of robotic cases was performed and pre-determined skill groups were tested. Nine metrics that make up the overall score were also tested via paired t test and subsequent logistic regression to determine which skills differed among experienced and novice robotic surgeons. Results: We enrolled 38 subjects with experience ranging from 0-< 200 robotic cases. Median time to complete both tasks was less than 10 min. The MScore on the first attempt was correlated to the number of previous robotic cases (R² = 0.465; p = 0.003). MScore was different between novice and more experienced robotic surgeons on the first (44.7 vs. 63.9; p = 0.005) and second attempt (56.0 vs. 69.9; p = 0.037). Conclusion: A single virtual simulator exercise can provide objective information in determining proficient use of the robotic surgical system.