Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training

• Published in: The American journal of surgery Vol. 194; no. 1; pp. 115 - 121
• Main Authors: Blavier, Adélaïde, Gaudissart, Quentin, Cadière, Guy-Bernard, Nyssen, Anne-Sophie
• Format: Journal Article Web Resource
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2007; Elsevier; Elsevier Limited; Excerpta Medica Inc-Elsevier Science Inc
• Subjects: Adult; Biological and medical sciences; Cameras; Chirurgie; Clinical Competence; Depth perception; Digestive system. Abdomen; Education, Medical, Undergraduate - methods; Endoscopy; Female; General aspects; General Surgery - education; Human health sciences; Humans; Imaging, Three-Dimensional; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Laparoscopy - statistics & numerical data; Learning curves; Male; Medical sciences; Movement freedom; questionnaire; Robotic surgery; Robotics; Robotics - statistics & numerical data; Robots; Sciences de la santé humaine; Skills; Surgery; Training; Visual Perception; Robotic surgery; Depth perception; Training; Learning curves; Laparoscopy; Movement freedom; Motion; Social perception; Curve; Depth; Robotics; Learning; Medicine; Treatment; Surgery; Transfer; Vocational aptitude; Endoscopy; Comparative study
• ISSN: 0002-9610; 1879-1883; 1879-1883
• DOI: 10.1016/j.amjsurg.2006.10.014

The purpose of this study was to evaluate the perceptual (2-dimensional [2D] vs. 3-dimensional [3D] view) and instrumental (classical vs. robotic) impacts of new robotic system on learning curves. Forty medical students without any surgical experience were randomized into 4 groups (classical laparoscopy with 3D-direct view or with 2D-indirect view, robotic system in 3D or in 2D) and repeated a laparoscopic task 6 times. After these 6 repetitions, they performed 2 trials with the same technique but in the other viewing condition (perceptive switch). Finally, subjects performed the last 3 trials with the technique they never used (technical switch). Subjects evaluated their performance answering a questionnaire (impressions of mastery, familiarity, satisfaction, self-confidence, and difficulty). Our study showed better performance and improvement in 3D view than in 2D view whatever the instrumental aspect. Participants reported less mastery, familiarity, and self-confidence and more difficulty in classical laparoscopy with 2D-indirect view than in the other conditions. Robotic surgery improves surgical performance and learning, particularly by 3D view advantage. However, perceptive and technical switches emphasize the need to adapt and pursue training also with traditional technology to prevent risks in conversion procedure.