Qualitative and quantitative analysis of the learning curve of a simulated surgical task on the da Vinci system

Author: Hernandez J.  

Publisher: Springer Publishing Company

ISSN: 0930-2794

Source: Surgical Endoscopy, Vol.18, Iss.3, 2004-03, pp. : 372-378

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Abstract

Robotic telemanipulation systems provide solutions to the problems of less dexterity and visual constraints of minimally invasive surgery (MIS). However, their influence over surgeons’ dexterity and learning curve needs to be assessed. We present motion analysis as an objective method to measure performance and learning progress. Thirteen surgeons completed five synthetic small bowel anastomoses using the da Vinci system. Objective Structured Assessment of Technical Skills (OSATS) allowed qualitative analysis. Quantitative analysis used API software of the system to retrieve real-time robotic signal data of time, path length, and number of movements. Wilcoxon signed ranks test was used for statistical analysis. A p value <0.05 was="" considered=""> OSATS global scores were 18.6 points for the first attempt and 26 for the fifth attempt (p < 0.02,="" cronbach’s="" alpha="0.894)." paired="" data="" of="" motion="" analysis="" for="" attempts="" 1="" vs="" 5="" showed="" significant="" change:="" time="" taken="" 3507="" sec="" and="" 2287="" sec="">p < 0.008),="" total="" number="" of="" movements="" 2411="" and="" 1387="">p = 0.01), total path length 21,630 cm and 13,941 cm (p = 0.01). A rapid learning curve to a competent level using the da Vinci system is possible aided by the system’s intuitive motion. Motion analysis is a useful tool to measure performance in the da Vinci system compared to OSATS and time alone.