1
|
Cope AG, Lazaro-Weiss JJ, Willborg BE, Lindstrom ED, Mara KC, Destephano CC, Vetter MH, Glaser GE, Langstraat CL, Chen AH, Martino MA, Dinh TA, Salani R, Green IC. Surgical Science - Simbionix Robotic Hysterectomy Simulator: Validating a New Tool. J Minim Invasive Gynecol 2022; 29:759-766. [PMID: 35123040 DOI: 10.1016/j.jmig.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE To gather validity evidence for and determine acceptability of Surgical Science - Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system and evaluate performance benchmarks between novice and experienced or expert surgeons. DESIGN Prospective education study (Messick validity framework) SETTING: Multi-center, academic medical institutions PARTICIPANTS: Residents, fellows, and faculty in Obstetrics and Gynecology were invited to participate at 3 institutions. Participants were categorized by experience level: less than 10 hysterectomies (novice), 10 to 50 hysterectomies (experienced), and greater than 50 hysterectomies (expert). A total of 10 novice, 10 experienced, and 14 expert surgeons were included. INTERVENTIONS Participants completed 4 simulator modules (ureter identification, bladder flap development, colpotomy, complete hysterectomy) and a qualitative survey. Simulator recordings were reviewed in duplicate by educators in minimally invasive gynecologic surgery using the Modified Global Evaluative Assessment of Robotic Skills (GEARS) rating scale. MEASUREMENTS AND MAIN RESULTS Most participants felt the simulator realistically simulated robotic hysterectomy (64.7%) and that feedback provided by the simulator was as or more helpful than feedback from previous simulators (88.2%) but less helpful than feedback provided in the OR (73.5%). Participants felt this simulator would be helpful for teaching junior residents. Simulator-generated metrics correlated with GEARS performance for bladder flap and ureter identification modules in multiple domains including total movements and total time for completion. GEARS performance for the bladder flap module correlated with experience level (novice vs experienced/expert) in domains of interest and total score but did not consistently correlate for the other procedural modules. Performance benchmarks were evaluated for the bladder flap module for each GEARS domain and total score. CONCLUSION The modules were well received by participants of all experience levels. Individual simulation modules appear to better discriminate between novice and experienced/expert users than overall simulator performance. Based on these data and participant feedback, use of individual modules in early residency education may be helpful for providing feedback and may ultimately serve as one component of determining readiness to perform robotic hysterectomy.
Collapse
Affiliation(s)
- Adela G Cope
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
| | - Jose J Lazaro-Weiss
- Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Brooke E Willborg
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA; Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | | | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Gretchen E Glaser
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie L Langstraat
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anita H Chen
- Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, Florida, USA
| | - Martin A Martino
- Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Tri A Dinh
- Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ritu Salani
- Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, California, USA
| | - Isabel C Green
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
2
|
Corrado G, Cutillo G, Mancini E, Baiocco E, Patrizi L, Saltari M, di Luca Sidozzi A, Sperduti I, Pomati G, Vizza E. Robotic single site versus robotic multiport hysterectomy in early endometrial cancer: a case control study. J Gynecol Oncol 2017; 27:e39. [PMID: 27171672 PMCID: PMC4864515 DOI: 10.3802/jgo.2016.27.e39] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/28/2016] [Accepted: 03/29/2016] [Indexed: 11/30/2022] Open
Abstract
Objective To compare surgical outcomes and cost of robotic single-site hysterectomy (RSSH) versus robotic multiport hysterectomy (RMPH) in early stage endometrial cancer. Methods This is a retrospective case-control study, comparing perioperative outcomes and costs of RSSH and RMPH in early stage endometrial cancer patients. RSSH were matched 1:2 according to age, body mass index, comorbidity, the International Federation of Gynecology and Obstetric (FIGO) stage, type of radical surgery, histologic type, and grading. Mean hospital cost per discharge was calculated summarizing the cost of daily hospital room charges, operating room, cost of supplies and length of hospital stay. Results A total of 23 women who underwent RSSH were matched with 46 historic controls treated by RMPH in the same institute, with the same surgical team. No significant differences were found in terms of age, histologic type, stage, and grading. Operative time was similar: 102.5 minutes in RMPH and 110 in RSSH (p=0.889). Blood loss was lower in RSSH than in RMPH (respectively, 50 mL vs. 100 mL, p=0.001). Hospital stay was 3 days in RMPH and 2 days in RSSH (p=0.001). No intraoperative complications occurred in both groups. Early postoperative complications were 2.2% in RMPH and 4.3% in RSSH. Overall cost was higher in RMPH than in RSSH (respectively, $7,772.15 vs. $5,181.06). Conclusion Our retrospective study suggests the safety and feasibility of RSSH for staging early endometrial cancer without major differences from the RMPH in terms of surgical outcomes, but with lower hospital costs. Certainly, further studies are eagerly warranted to confirm our findings.
Collapse
Affiliation(s)
- Giacomo Corrado
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
| | - Giuseppe Cutillo
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Emanuela Mancini
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Ermelinda Baiocco
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Lodovico Patrizi
- Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy
| | - Maria Saltari
- Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy
| | - Anna di Luca Sidozzi
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Isabella Sperduti
- Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Pomati
- Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy
| | - Enrico Vizza
- Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy
| |
Collapse
|