Robotic Surgeons Need Skill Assessment Tools

October 2, 2014

Evidence is mounting that robotic surgeons of any training level show significant improvement after a formal skill assessment process.

As robot-assisted microsurgeries continue to gain traction, efforts to assess a surgeon’s abilities are also being developed and show promise of improving the skill sets needed for the newest technology.

Pertinent Points

- In a small study, plastic surgeons in Texas validated an assessment tool for evaluating the skills used in robotic microsurgery.

- In describing the efforts, the surgeons suggest that the standardized evaluation should be used to improve the skill sets of surgeons at various levels of education, especially given the vast changes in robotic surgery technologies.

- There is nearly limitless potential for robotic precision, but this can never be realized without proper training and skill assessment.

Among the latest efforts to ascertain the learning curve is a tool developed by plastic surgeons in Texas. Researchers described the validation of a new assessment tool for robotic microsurgeries. The surgery evaluated was microvascular anastomosis. For OB/GYNs, robotic microsurgery seems to be gaining the most ground in the reproductive endocrinology realm, specifically for tubal reversals and reconstruction.

For this experiment, four experts reviewed 6 microsurgeries, and interrater reliability was determined to be "excellent." From there, the tool was successful in evaluating five robotic skills and in documenting improvements in the participants over time.

The tool, dubbed the Structured Assessment of Robotic Microsurgical Skills, was studied among a small group of surgeons that included both experts and trainees. In all, 10 surgeons from The University of Texas MD Anderson Cancer Center’s Department of Plastic and Reconstructive Surgery participated using a da Vinci robot.

The researchers said by using the evaluation tool, they were able to show improvement in robotic microsurgical skills among all the participants. With notable improvement in skills and overall performance, the authors suggest that practice can help surgeons of all skill levels reach competency. In fact, all 10 surgeons, who ranged from minimal training in microsurgery to experts, gained proficiency over the course of the robotic skill–assessment sessions and steadily decreased their operative time.

“Standardized evaluation and systematic learning of both robotic and conventional surgical techniques is necessary, and is the foundation of competency-based training, which itself is the future of surgical education,” they concluded.