Robotic-assisted surgeries can be good for patients and good for the hospital's bottom line, but a hang up for medical staffs is that it's not easy to train surgeons on these systems.
That's where the new Robotic Surgical Simulator, or RoSS, comes in. Designed by researchers from the University at Buffalo and Roswell Park Cancer Institute (RPCI), RoSS uses simulation technology borrowed from the airline industry with the goal of providing a relatively inexpensive and quick training solution for today's surgeons.
RoSS wasn't designed specifically for da Vinci surgical training, one of the most popular systems on the market. Rather, it teaches the techniques employed by all robotic surgical systems.
Credentials committee will have to wait a little while before reviewing the competency data from RoSS-trained surgeons. Orders for the finished RoSS modules are scheduled to be delivered in January 2011.
Although the makers of RoSS came from varied backgrounds, the training problems facing robotics-assisted surgeons were clear to all.
"Robotic-assisted surgery systems are relatively new and right now there's no systematic way of training surgeons for the robot other than going to the animal lab, for instance, or shadowing, where a doctor gets a chance to sit with the experienced surgeon," says Thenkurussi ("Kesh") Kesavadas, PhD, professor of mechanical and aerospace engineering at the University of Buffalo and head of its Virtual Reality Lab.
Even the technique of shadowing another surgeon can have its disadvantages, especially when it comes to training on the popular da Vinci Surgical System.
"The problem right now is it's a $2 million robot, it's in the OR, the administration wants you to do more cases rather than training people, and a lot of surgeons feel intimidated by it," says Khurshid A. Guru, MD, director of the Center for Robotic Surgery and attending surgeon in RPCI's Department of Urology. "You need to have a simulation-based curriculum."
How does this simulation training device work? RoSS training is divided into three levels:
- Motor skills section. This basic section teaches surgeons the hand-eye coordination skills needed to work with the robotic program through a series of exercises.
- Clinical applications. After the surgeon masters the basic maneuverability skills, he or she learns how to do different elements of a procedure, such as working with a needle.
- Procedures. Surgeons are called on to apply the lessons they learned in the first two sections to work on simulated procedures. Currently, the two procedures RoSS simulates are hysterectomies and prostatectomy because those are the most widely performed robotic surgery procedures.
"The simulation has been designed in such a way that with a five-minute introduction, anybody could sit on it and start working," says Kesavadas.
The five-minute introduction is built into the simulation unit and teaches the practitioner how to use RoSS through audio, video, and text instructions. It teaches the RoSS user similar to the way a trained robotics surgeon would teach a new practitioner by first pointing out the various elements and instructing the user to touch them.
If a medical staff wants to increase the training of its robotics surgeons in the future, the devices' creators hope one option will be to use the RoSS.
"In certain metropolitan areas, it's easier to find good surgeons. But you look at community hospitals and hospitals in rural areas, if they buy a robot, it's very tough to get a surgeon to use it, and that is probably what has stopped its explosive growth," says Kesavadas.
"Simulation is really one of the keys to overcoming this problem."
For more information ,download HCPro's Clinical Privilege White Paper: Robotic-assisted surgery - Procedure 421, which is available online at www.CredentialingResourceCenter.com (subscription required).
Emily Berry is an associate editor for Briefings on Credentialing and Credentialing Resource Center Connection, and manages the Credentialing Resource Center. You can reach her at eberry@hcpro.com.