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Procedural virtual reality simulation training for robotic surgery: a randomised controlled trial

Research output: Contribution to journalArticlepeer-review

Nicholas Raison, Patrick Harrison, Takashige Abe, Abdullatif Aydin, Kamran Ahmed, Prokar Dasgupta

Original languageEnglish
Pages (from-to)6897-6902
Number of pages6
JournalSurgical endoscopy
Issue number12
Early online date4 Jan 2021
Accepted/In press2021
E-pub ahead of print4 Jan 2021
PublishedDec 2021

Bibliographical note

Funding Information: Drs. N. Raison, P. Harrison, T. Abe, A. Aydin, K. Ahmed, P. Dasgupta have no conflicts of interest or financial ties to disclose. The study was supported by 3D Systems, Inc. with the loan of the RobotiX Mentor Simulator only. 3D Systems, Inc. provided no other support and had no input in the study or manuscript. The manuscript was not shown to 3D Systems, Inc. staff prior to submission. Dr. Nicholas Raison acknowledges research support by the Vattikuti Foundation. Publisher Copyright: © 2020, The Author(s).

King's Authors


Background: Virtual reality (VR) training is widely used for surgical training, supported by comprehensive, high-quality validation. Technological advances have enabled the development of procedural-based VR training. This study assesses the effectiveness of procedural VR compared to basic skills VR in minimally invasive surgery. Methods: 26 novice participants were randomised to either procedural VR (n = 13) or basic VR simulation (n = 13). Both cohorts completed a structured training programme. Simulator metric data were used to plot learning curves. All participants then performed parts of a robotic radical prostatectomy (RARP) on a fresh frozen cadaver. Performances were compared against a cohort of 9 control participants without any training experience. Performances were video recorded and assessed blindly using GEARS post hoc. Results: Learning curve analysis demonstrated improvements in technical skill for both training modalities although procedural training was associated with greater training effects. Any VR training resulted in significantly higher GEARS scores than no training (GEARS score 11.3 ± 0.58 vs. 8.8 ± 2.9, p = 0.002). Procedural VR training was found to be more effective than both basic VR training and no training (GEARS 11.9 ± 2.9 vs. 10.7 ± 2.8 vs. 8.8 ± 1.4, respectively, p = 0.03). Conclusions: This trial has shown that a structured programme of procedural VR simulation is effective for robotic training with technical skills successfully transferred to a clinical task in cadavers. Further work to evaluate the role of procedural-based VR for more advanced surgical skills training is required.

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