Korean J Urol.  2015 Nov;56(11):756-761. 10.4111/kju.2015.56.11.756.

Concurrent and predictive validation of robotic simulator Tube 3 module

• Kim JY
• Kim SB
• Pyun JH
• Kim HK
• Cho S
• Lee JG
• Kim JJ
• Cheon J
• Kang SH
• Kang SG

• KMID: 2351038
• DOI: http://doi.org/10.4111/kju.2015.56.11.756

Abstract

PURPOSE
We previously described a new procedure specific module (Tube 3) to allow the practice of vesicourethral anastomosis after robot-assisted radical prostatectomy. Herein, we report a predetermined proficiency level of Tube 3 and preliminary validation to explore whether this new module can lead to performance improvement in the da Vinci system.
MATERIALS AND METHODS
Eight urology residents and three urology fellows performed the Tube 3 module 1 hour daily for 7 days. The learning curve was depicted through a scatterplot and the stable point was identified through the cumulative sum chart. Concurrent and predictive validations were performed with the da Vinci system. The mean time to complete the task and end product rating score between Tube 3 training group and no Tube 3 training group were compared.
RESULTS
Concerning the learning curve, about 41 repetitions comprising about 5 hours were needed to achieve this stable point when the mean time to complete Tube of 384 seconds was set as a target. With regarding to the concurrent and predictive validation, there significant differences were evident in the mean time to complete 16 needle passages and the vesicourethral anastomosis and the end product rating score.
CONCLUSIONS
The virtual reality (VR) simulator can yield sufficient improvement in technical performance in Tube 3 within 5 hours. The acquired proficiency can be transferable to the vesicourethral anastomosis using the da Vinci system.

Keyword

Computer simulation; Learning curve; Robotics

MeSH Terms

Anastomosis, Surgical/methods
Clinical Competence
Computer Simulation
Education, Medical, Graduate/*methods
Humans
Learning Curve
Male
Prostatectomy/*education/methods
Robotic Surgical Procedures/*education/methods
Simulation Training/methods
Urethra/surgery
Urinary Bladder/surgery
User-Computer Interface

Figure

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  Fig. 1 The synthetic double layer bowel 30-mm OD used for concurrent validation (length 200 mm; Limbs and Things, Bristol, England).

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  Fig. 2 Vesicourethral anastomosis kit used for predictive validation (Limbs and Things, Bristol, England).

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  Fig. 3 Learning curve of Tube 3 module using a scatter plot.

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  Fig. 4 Cumulative sum (CUSUM) graph of Tube 3 module.

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