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Browsing by Subject "Robotic surgery"
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Item Augmenting mental imagery for robotic surgery using neurofeedback: results of a randomized controlled trial(Springer Nature, 2023) Anton, Nicholas E.; Ziliak, Meredith C.; Stefanidis, Dimitrios; Surgery, School of MedicineBackground: Mental imagery (MI) can enhance surgical skills. Research has shown that through brain-computer interface (BCI), it is possible to provide feedback on MI strength. We hypothesized that adding BCI to MI training would enhance robotic skill acquisition compared with controls. Methods: Surgical novices were recruited. At baseline, participants completed the Mental Imagery Questionnaire (MIQ) and the Vandenburg Mental Rotation Test (MRT). Students also performed several tasks on a robotic simulator. Participants were stratified based on MIQ and robotic skill and randomized into three groups: controls, MI, and MI and BCI training. All participants completed five 2-h training sessions. One hour was devoted to practicing robotic skill on the simulator. Additionally, controls completed crosswords for one hour, the MI group completed MI training and crosswords for one hour, and the MI + BCI group completed MI training and MI-related BCI training. Following training, participants completed the same baseline assessments. A Kruskal-Wallis test was used to determine differences between groups. Mann-Whitney U tests were performed to determine specific differences between groups. Results: Twenty-seven undergraduates participated. There were post-test differences on the MRT and knot tying task. Sub-analyses revealed that the MI + BCI group significantly outperformed the other groups on knot tying. There were no appreciable differences between the control and MI groups on any measures. Conclusions: Augmenting MI training with BCI led to significantly enhanced MI and robotic skill acquisition than traditional MI or robotic training methods. To optimize surgical skill acquisition in robotic and other surgical skills curricula, educators should consider utilizing MI with BCI training.Item Demonstrating the effectiveness of the fundamentals of robotic surgery (FRS) curriculum on the RobotiX Mentor Virtual Reality Simulation Platform(Springer, 2021-04) Martin, John Rhodes; Stefanidis, Dimitrios; Dorin, Ryan P.; Goh, Alvin C.; Satava, Richard M.; Levy, Jeffrey S.; Surgery, School of MedicineFundamentals of robotic surgery (FRS) is a proficiency-based progression curriculum developed by robotic surgery experts from multiple specialty areas to address gaps in existing robotic surgery training curricula. The RobotiX Mentor is a virtual reality training platform for robotic surgery. Our aims were to determine if robotic surgery novices would demonstrate improved technical skills after completing FRS training on the RobotiX Mentor, and to compare the effectiveness of FRS across training platforms. An observational, pre-post design, multi-institutional rater-blinded trial was conducted at two American College of Surgeons Accredited Education Institutes-certified simulation centers. Robotic surgery novices (n = 20) were enrolled and trained to expert-derived benchmarks using FRS on the RobotiX Mentor. Participants’ baseline skill was assessed before (pre-test) and after (post-test) training on an avian tissue model. Tests were video recorded and graded by blinded raters using the Global Evaluative Assessment of Robotic Skills (GEARS) and a 32-criteria psychomotor checklist. Post hoc comparisons were conducted against previously published comparator groups. On paired-samples T tests, participants demonstrated improved performance across all GEARS domains (p < 0.001 to p = 0.01) and for time (p < 0.001) and errors (p = 0.003) as measured by psychometric checklist. By ANOVA, improvement in novices’ skill after FRS training on the RobotiX Mentor was not inferior to improvement reported after FRS training on previously published platforms. Completion of FRS on the RobotiX Mentor resulted in improved robotic surgery skills among novices, proving effectiveness of training. These data provide additional validity evidence for FRS and support use of the RobotiX Mentor for robotic surgery skill acquisition.Item Emergency Undocking Curriculum in Robotic Surgery(Cureus, 2019-03-26) Ballas, Derek A.; Cesta, Megan; Gothard, David; Ahmed, Rami; Emergency Medicine, School of MedicineIntroduction Traditional instruction for robotic surgery is typically devoid of training that addresses the delineation of interprofessional roles for operating room personnel. An emergency undocking scenario was developed for robotic surgeons with the objectives of improving time to access the patient, provider knowledge of and confidence in emergency undocking, completion of predetermined critical actions, and delineation of operating room personnel roles. Methods Over one month, participants joined in three sessions: Session 1 - formative, Session 2 - review, and Session 3 - summative. Embedded standardized participants (ESPs) represented members of the interprofessional team. Prior to entering the operating room for Sessions 1 and 3, trainees were asked to complete a confidence survey and multiple choice questionnaire (MCQ) for knowledge assessment. Participants were randomized to one of two cases and participated in the reciprocal case for the final session four weeks later. Following Session 1, participants underwent an educational intervention, including the proper technique for emergency undocking, emphasis on operating room personnel roles, and hands-on practice. Obstetrics and Gynecology (OBGYN) residents in post-graduate Years 2-4 and attending physicians with robotics privileges at Summa Health Akron Campus or Cleveland Clinic Akron General Medical Center were invited to participate. A total of 21 participants enrolled and finished the study. Results Among the 21 participants, there was a significant increase in the baseline level of knowledge (p-value=0.001) and in the confidence of surgeons when faced with an emergency undocking after the completion of our curriculum (p-value=0.003). Additionally, an improvement in the undocking times (p-value<0.001) and an increase in the critical actions performed (p-value=0.002) were observed. Conclusion The results of this study demonstrate that incorporating this curriculum into the training programs of robotic surgeons is an effective way to improve the surgical skill of emergency undocking.Item Sensor-based indicators of performance changes between sessions during robotic surgery training(Elsevier, 2021) Wu, Chuhao; Cha, Jackie; Sulek, Jay; Sundaram, Chandru P.; Wachs, Juan; Proctor, Robert W.; Yu, Denny; Urology, School of MedicineTraining of surgeons is essential for safe and effective usage of robotic surgery, yet current assessment tools for learning progression are limited. The objective of this study was to measure changes in trainees’ cognitive and behavioral states as they progressed in a robotic surgeon training curriculum at a medical institution. Seven surgical trainees in urology who had no formal robotic training experience participated in the simulation curriculum. They performed 12 robotic skills exercises with varying levels of difficulty repetitively in separate sessions. EEG (electroencephalogram) activity and eye movements were measured throughout to calculate three metrics: engagement index (indicator of task engagement), pupil diameter (indicator of mental workload) and gaze entropy (indicator of randomness in gaze pattern). Performance scores (completion of task goals) and mental workload ratings (NASA-Task Load Index) were collected after each exercise. Changes in performance scores between training sessions were calculated. Analysis of variance, repeated measures correlation, and machine learning classification were used to diagnose how cognitive and behavioral states associate with performance increases or decreases between sessions. The changes in performance were correlated with changes in engagement index (rrm = −.25, p < .001) and gaze entropy (rrm = −.37, p < .001). Changes in cognitive and behavioral states were able to predict training outcomes with 72.5% accuracy. Findings suggest that cognitive and behavioral metrics correlate with changes in performance between sessions. These measures can complement current feedback tools used by medical educators and learners for skills assessment in robotic surgery training.Item The first SURS World Congress of Robotic Surgery at Mount Sinai Hospital in New York City: A tribute to the past and the future of robotic urologic surger(Wiley, 2023-02-14) Gupta, Raghav; Chopra, Deepak; Hemal, Ashok K.; Mukherjee, Siddhartha; Rogers, Craig G.; Sundaram, Chandru P.; Tewari, Ashutosh K.; Urology, School of MedicineItem Training the next generation of surgeons in robotic surgery(Dovepress, 2017-04-21) Carpenter, Benjamin T.; Sundaram, Chandru P.; Urology, School of MedicineContext: Robotic surgery has been used with rapidly increasing frequency within urology and across many other surgical specialties. A standardized curriculum for the training and credentialing of robotic surgeons has unfortunately trailed far behind the adoption of this surgical technology. Objective: To review the current available surgical skills training models, assessments, and curricula for the purpose of training resident, fellow, and practicing surgeons in an effort to promote surgical skill proficiency and mastery and to minimize the risk of patient harm. Evidence acquisition: We performed a thorough review of available literature through a PubMed database search in February 2015. Evidence synthesis: In this article, we compiled and scrutinized the available relevant literature regarding past and present robotic surgical training techniques and credentialing criteria. This review details the basic surgical skills (both technical and nontechnical) that are necessary for individuals and teams to be successful in the operative setting. We go on to discuss the role of current robotic surgical training techniques including dry lab and virtual simulators. Finally, we offer current validated training curricula, the Global Evaluative Assessment of Robotic Skills and Fundamentals of Robotic Surgery models, which have laid the groundwork for a future standardized model that could be applied on a national and international level and across several surgical subspecialties. The ultimate goal of the review is to provide a foundation from which a future standardized training and credentialing curriculum could be based. Conclusion: There is currently a great need for a standardized curriculum to be developed and employed for the use of training and credentialing future and current robotic surgeons.