Initial validation of a virtual-reality robotic simulator

Abstract
Robotic surgery is an accepted adjunct to minimally invasive surgery, but training is restricted to console time. Virtual-reality (VR) simulation has been shown to be effective for laparoscopic training and so we seek to validate a novel VR robotic simulator. The American Urological Association (AUA) Office of Education approved this study. Subjects enrolled in a robotics training course at the 2007 AUA annual meeting underwent skills training in a da Vinci dry-lab module and a virtual-reality robotics module which included a three-dimensional (3D) VR robotic simulator. Demographic and acceptability data were obtained, and performance metrics from the simulator were compared between experienced and nonexperienced roboticists for a ring transfer task. Fifteen subjects—four with previous robotic surgery experience and 11 without—participated. Nine subjects were still in urology training and nearly half of the group had reported playing video games. Overall performance of the da Vinci system and the simulator were deemed acceptable by a Likert scale (0–6) rating of 5.23 versus 4.69, respectively. Experienced subjects outperformed nonexperienced subjects on the simulator on three metrics: total task time (96 s versus 159 s, P < 0.02), economy of motion (1,301 mm versus 2,095 mm, P < 0.04), and time the telemanipulators spent outside of the center of the platform’s workspace (4 s versus 35 s, P < 0.02). This is the first demonstration of face and construct validity of a virtual-reality robotic simulator. Further studies assessing predictive validity are ultimately required to support incorporation of VR robotic simulation into training curricula.