Robotic Instructional Platform for Surgery on the Abdominal Wall: A Validation Study for a Novel Simulation Model

Introduction – Ventral hernia repair is a common procedure performed by general surgeons, with approximately 400, 000 performed each year in the United States. Robotic ventral hernia repairs (rVHRs) continue to increase, and simulation is vital for robotic skills acquisition; however, a realistic rVHR training platform does not currently exist. The goal of this study was to assess a novel rVHR model for robotic simulation training and to compare baseline rVHR experience with performance of rVHR simulated tasks. Methods – The Robotic Instructional Platform for Surgery on the Abdominal Wall (RIP SAW) was developed via an iterative process for use with the da Vinci Surgical System. Staff general surgeons, surgical residents, and medical students were recruited at a single military academic institution. All participants completed an assessment trial designed to mimic rVHR. Staff surgeons answered questions about model fidelity and realism. Performances on the tasks were compared between subgroups based on time and composite score. Results – All staff surgeons who participated reported that the model was acceptable for rVHR simulation training. There was a significant difference in composite scores between groups (F(2, 21) = 66.75, P < 0.001, η2 = 0.86). There was also a significant difference in operative times between groups (F(2, 21) = 17.34, P < 0.001, η2 = 0.62). A linear regression using total career rVHRs performed as a predictor demonstrated a significant correlation between rVHR cases and composite score (F(1, 22) = 6.55, P = 0.018). Conclusions – The RIP SAW is a novel cost-effective model for rVHR simulation training. Pilot testing demonstrated evidence of fidelity and validity and provides a unique nonvirtual reality option for robotic surgery training.