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Abstract
Robot-assisted surgery is a complex surgical method, with special requirements on surgeons performing it. Since its introduction into medicine, it spread to a wide variety of specialties. Effective training methods are required to learn robotic surgical skills outside the operating room. Such a method is the da Vinci Skills Simulator, which was developed by ‘Intuitive Surgical’ in cooperation with ‘Mimic Technologies’. In order to enable the development of a standardized training, various studies investigated different factors influencing the training on the simulator. However, there is little data available on the influence of age. The present study aims to fill this lack of knowledge and to find out whether one age group is possibly better than another in learning technical skills for robotic surgery. A total of 60 robotic novices were tested in this prospective study on the da Vinci Skills Simulator between December 2014 and September 2016. Based on their age, the subjects were divided into three groups of 20 subjects each. Group 1 was made up of subjects aged 20-29 years, Group 2 of 30-39 years, and Group 3 of ≥40 years. Males and females were equally represented in the groups. Each group performed the same four exercises (Match Board 1, Peg Board 2, Ring & Rail 2, Energy & Dissection 3) on the da Vinci Skills Simulator with different focuses and levels of difficulty. Each of these exercises was repeated a total of six times on two different dates (day 1: exercises 1-3, day 2: exercises 4-6), with a one-week interval between sessions. At the end of the second session, the subjects also completed a questionnaire. After successful completion of each exercise, the performance was shown in form of various parameters (Time To Complete Exercise, Economy of Motion, Master Workspace Range, Instrument Collisions, Excessive Instrument Force, Instruments Out Of View, Drops, Misapplied Energy Time, Blood Loss Volume and Broken Vessels) and combined into an Overall Score.
The training resulted in significant skill gains in the main parameters (Overall Score, Time To Complete Exercise, Economy of Motion) in all exercises for all three groups. In the group comparison, the most prominent differences were found between groups 1 and 3, with the first group frequently showing significantly better results in Overall Score and Economy of Motion, both at the beginning and at the end of the exercises. Group 1 was also significantly faster in the more difficult exercises. Even in the trials in which it did not perform significantly better than the third group, group 1 usually achieved better results and was able to complete the exercises faster. The second group also frequently achieved a better result compared to the third, but there were fewer significant differences. Again, the greatest differences were seen in the more difficult exercises. Although there were only a few significant differences between groups 1 and 2, group 1 also usually had the better result, especially in the more difficult exercises. Groups 1 and 2 reached Overall Scores of ≥80%, which is the target performance level according to the developer's recommendation, in all four exercises after the sixth repetition. Group 3 only reached this in the two easy exercises (Match Board 1, Peg Board 2). However, in three exercises (Match Board 1, Peg Board 2, Energy & Dissection 3) the third group showed the largest learning curve from the first to the sixth attempt. The results show that all age groups investigated benefit from training on the da Vinci Skills Simulator. In addition, it could be shown that the older subjects often achieved poorer scores compared to the younger subjects and needed more time to perform similarly. This is especially noticeable in the more difficult tasks. In view of the results, it is recommended that standardized training should not be limited to a fixed number of repetitions or a specific training time. Reaching and keeping a predefined performance level seems to be the better choice in respect of different age groups. Also, older trainees may benefit from shorter training breaks and a higher number of repetitions of the individual exercises.
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Issued: 2025-07-09
Faculty
FB20:Medizin
Language
de
Keywords
da Vinci Skills SimulatorRoboter-assistierte ChirurgieAlter
DFG-subjects
205-13 Pneumologie, Thoraxchirurgie205-21 Gynäkologie und Geburtshilfe205-23 Reproduktionsmedizin, Urologie205-25 Allgemein- und Viszeralchirurgie205-29 Hals-Nasen-Ohrenheilkunde205-27 Orthopädie, Unfallchirurgie, rekonstruktive Chirurgie
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Lenz, Charlotte: Einfluss des Alters auf die Performance am da Vinci Skills Simulator. : 2025-07-09.
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This item has been published with the following license: In Copyright