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Evaluation of high‐fidelity simulation as a training tool in transoral robotic surgery
Author(s) -
Bur Andrés M.,
Gomez Ernest D.,
Newman Jason G.,
Weinstein Gregory S.,
O'Malley Bert W.,
Rassekh Christopher H.,
Kuchenbecker Katherine J.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26733
Subject(s) - transoral robotic surgery , fidelity , medicine , medical physics , physical therapy , simulation , surgery , computer science , telecommunications
Objectives/Hypothesis To develop and evaluate a high‐fidelity training simulator for transoral robotic posterior hemiglossectomy. Study Design Prospective observational study. Methods We constructed a transoral robotic surgery (TORS) simulator using porcine tongue in a modified airway mannequin. Twenty‐nine surgeons performed transoral robotic posterior hemiglossectomy on the simulator. The 20 resident subjects completed six trials each, and the five fellows and four attending surgeons completed two trials each. In addition to instrument vibrations, surgical video was recorded for each trial and was blindly rated using the Global Evaluative Assessment of Robotic Skill (GEARS), a validated instrument for assessing robotic surgical skill. Results Attending surgeons were faster ( P = .004) and demonstrated greater technical skill than fellows or residents ( P < .001). Resident completion time generally decreased over the study, becoming significantly faster by the fifth trial ( P = .02). A similar trend was seen in resident GEARS scores, which generally increased and were significantly improved by the fourth trial ( P = .008). Instrument vibrations were not significantly different between subject groups. Finally, subjects highly rated the realism and training value of the TORS simulator (mean 4.4 and 4.7 out of 5, respectively). Conclusions The reported findings support using the described simulator as a training tool for TORS. Residents significantly improved in speed and technical skill over the course of six trials but did not achieve the performance levels of attending surgeons. These results demonstrate that high‐fidelity simulation is a valuable tool for training novice surgeons in transoral robotic surgery. Level of Evidence NA. Laryngoscope , 127:2790–2795, 2017