Objective evaluation of expert and novice performance during robotic surgical training tasks

Robotic laparoscopic surgery has revolutionized minimally invasive surgery for the treatment of abdominal pathologies. However, current training techniques rely on subjective evaluation. The authors sought to identify objective measures of robotic surgical performance by comparing novices and experts during three training tasks. Five novices (medical students) were trained in three tasks with the da Vinci Surgical System. Five experts trained in advanced laparoscopy also performed the three tasks. Time to task completion (TTC), total distance traveled (D), speed (S), curvature (kappa), and relative phase (I broken vertical bar) were measured. Before training, TTC, D, and kappa were significantly smaller for experts than for novices (p < 0.05), whereas S was significantly larger for experts than for novices before training (p < 0.05). Novices performed significantly better after training, as shown by smaller TTC, D, and kappa, and larger S. Novice performance after training approached expert performance. This study clearly demonstrated the ability of objective kinematic measures to distinguish between novice and expert performance and training effects in the performance of robotic surgical training tasks.