Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines

Authors

  • Tarek Alzahrani McGill University
  • Richard Haddad McGill University
  • Abdullah Alkhayal McGill University
  • Josee Delisle McGill University
  • Laura Drudi
  • Walter Gotlieb
  • Shannon Fraser
  • Simon Bergman
  • Frank Bladou
  • Sero Andonian
  • Maurice Anidjar

DOI:

https://doi.org/10.5489/cuaj.419

Keywords:

Robotics, simulation, surgical education, minimally invasive surgery

Abstract

Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines.

Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1-74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pairwise comparisons.

Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05).

Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts.

Downloads

Download data is not yet available.

References

Healy GB. The college should be instrumental in adapting simulators to education. Bull Am Coll Surg 2002; 87(11):10-1.

Fried GM. FLS assessment of competency using simulated laparoscopic tasks. J Gastrointest surg 2008; 12(2):210-2.

Dauster B, Steinberg AP, Vassiliou MC, et al. Validity of the MISTELS simulator for laparoscopy training in urology. J Endourol 2005; 19(5):541-5.

Sweet RM, Beach R, Sainfort F, et al. Introduction and validation of the American Urological Association Basic Laparoscopic Urologic Surgery skills curriculum. J Endourol 2012; 26(2):190-6.

Stefanidis D, Hope WW, Scott DJ. Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy. Surg Endosc 2011; 25(7):2141-6.

Medical Advisory Secretariat. Robotic-assisted minimally invasive surgery for gynecologic and urologic oncology: an evidence-based analysis. Ont Health Technol Assess Ser [Internet]. 2010 December [cited:2012-12-28]; 10(27) 1-118. Available from:

http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_robotic_surgery_20101220.pdf

Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, Chandrasekhar R, Wilding GE, Guru KA. Face validation of a novel robotic surgical simulator. Urology 2010; 76(2):357-60.

Seixas-Mikelus SA, Stegemann AP, Kesavadas T, et al. Content validation of a novel robotic surgical simulator. BJU int 2011; 107(7):1130-5.

Lendvay TS, Casale P, Sweet R, Peters C. VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Stud Health Technol Inform 2008; 132:242-4.

Kenney PA, Wszolek MF, Gould JJ, Libertino JA, Moinzadeh A. Face, content, and construct validity of dV-trainer, a novel virtual reality simulator for robotic surgery. Urology 2009; 73(6):1288-92.

Sethi AS, Peine WJ, Mohammadi Y, Sundaram CP. Validation of a novel virtual reality robotic simulator. J Endourol 2009; 23(3):503-8.

Raman JD, Dong S, Levinson A, Samadi D, Scherr DS. Robotic radical prostatectomy: operative technique, outcomes, and learning curve. JSLS 2007; 11(1):1-7.

Hung AJ, Zehnder P, Patil MB, et al. Face, content and construct validity of a novel robotic surgery simulator. J Urol 2011; 186(3):1019-24.

Kelly DC, Margules AC, Kundavaram CR, et al. Face, content, and construct validation of the Da Vinci Skills Simulator. Urology. 2012;79(5):1068-72.

Liss MA, Abdelshehid C, Quach S, et al. Validation, correlation, and comparison of the da vinci trainer and the da vinci surgical skills simulator using the mimi software for urologic robotic surgical education. J Endourol . 2012;26(12):1629-34.

Finnegan KT, Meraney AM, Staff I, Shichman SJ. da Vinci Skills Simulator construct validation study: correlation of prior robotic experience with overall score and time score simulator performance. Urology. 2012;80(2):330-5.

Teishima J, Hattori M, Inoue S, et al. Impact of laparoscopic experience on the proficiency gain of urologic surgeons in robot-assisted surgery. J Endourol. 2012;26(12):1635-8.

Downloads

Published

2013-07-02

How to Cite

Alzahrani, T., Haddad, R., Alkhayal, A., Delisle, J., Drudi, L., Gotlieb, W., Fraser, S., Bergman, S., Bladou, F., Andonian, S., & Anidjar, M. (2013). Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines. Canadian Urological Association Journal, 7(7-8), E520–9. https://doi.org/10.5489/cuaj.419

Issue

Section

Original Research