65Robotic-Assisted Laparoscopic Surgery Training
and Assessment Platforms
Simulators
The da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) is currently the most
widely used surgical robot and is the only surgical robot approved for use in the
United States by the Food and Drug Administration (FDA).
Intuitive Surgical Inc. (ISI) provides a four-step training pathway for the da
Vinci. The first phase includes an online course, procedural video review, and
robotic system in service guided by an ISI representative [ 20 ]. Prospective surgeons
then proceed with skill development during phase two. Here, surgeons work to
develop proficiency on critical skills, using multiple forms of simulation [ 20 ].Phase
three works to introduce more advanced techniques and instrumentation to the
developing robotic surgeon, as well as gaining experience as the bedside assistant in
surgical cases [ 20 ]. By the fourth phase, surgeons will take on the role of console
surgeon [ 20 ]. Each step has recommended time commitments, ideal scoring ranges,
and case involvement.
Many hospitals and simulation centers also offer both wet and dry surgical train-
ing labs, which may be supported by personnel from ISI or external simulation
companies and also by in-house simulation technicians. The majority of facilities
will only house one simulator, but institutions specializing in training MIS tech-
niques have the capacity to train in a group setting, demonstrated in Fig. 5.11.
Additionally, as with open surgery and laparoscopic surgery, junior robotic sur-
geons often perform partial procedures, with a senior surgeon observing and the
option of performing more difficult parts of the procedure. The dual console
Fig. 5.11 Group simulation with Mimic dV-Trainer
5 Performance Assessment in Minimally Invasive Surgery