Survey: Simulation robot training should be mandatory

Buffalo, NY-A new survey of urologic surgeons from around the world found that an overwhelming majority believes simulation-based training (SBT) for robot-assisted surgery should be a mandatory part of their surgical programs. However, most of the surgeons have never used a simulator, and most respondents from clinics outside North America said they don’t have simulators at their institutions.

The findings of the survey, presented at the AUA annual meeting in San Diego, point to the importance of boosting the use of simulators, said co-author Johar Syed, MD, a fellow in uro-oncology at the Roswell Park Cancer Institute in Buffalo, NY.

“All across the globe, people strongly appreciate the fact that simulation-based training should be part of the curriculum. But despite the fact that surgeons are operating with these robots, few centers are offering simulation-based training to their trainees. And those that do devote limited dedicated time to it,” Dr. Syed told Urology Times.

According to Dr. Syed, SBT is crucial for surgeons who are learning robot-assisted surgery.

“When you start operating via a robot, you are at a distance from the patient and don’t get any direct feedback. You have to master that interface deficit before you start operating on a patient,” added Dr. Syed, who worked on the study with Khurshid Guru, MD, and colleagues.

SBT is also useful because it helps experienced surgeons warm up before performing a procedure, he said.

With the survey, the authors sought to understand how urologic surgeons perceive SBT as a tool in training and in the operating room itself.

A total of 358 urologic surgeons (127 training directors/coordinators, 151 attending surgeons, and 80 fellows/residents) completed the anonymous online survey in mid-2012. They answered 40 multiple-choice questions regarding their backgrounds, experience with surgical simulation, institutional status regarding SBT, and personal feelings about its use.

More than 60% have never used simulators

Of the respondents, 74.9% had performed robot-assisted surgery or had a robotic surgical system in their institution; 64.4% have never worked on training simulators; and 54.9% didn’t have surgical simulators in their institutions.

Just over 85% believe SBT should be a mandatory part of their surgical program, and 92% believe there should be dedicated time for SBT for new trainees.

In regard to pre-surgery warm-up via SBT, 46.8% said it’s a good idea (77.3% in regions outside North America and Europe but only 42.7% in North America and 44.9% in Europe).

There were other differences by geography. In North America, 97% of surgeons said their institution featured a robotic surgical system, Dr. Syed said. That number dropped to 38% in Europe.

The challenges to the use of SBT include its cost and lack of local resource centers around the world to provide simulator training, Dr. Syed said.

“Surgeons fly in from all over the world to our center,” he pointed out.UT

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