Vanderbilt University Medical Center’s Irving Zamora, MD, MPH, assistant professor of Pediatric Surgery, and Aimal Khan, MD, assistant professor of Surgery, have received a grant to support the development and validation of an objective robotic skills assessment tool for surgical trainees.
The two-year grant from the Association for Surgical Education (ASE) is a Center for Excellence in Surgical Education, Research and Training Giant Robot Award.
Current robotic skills assessment measures for surgical trainees are both cumbersome and require another surgeon to evaluate them, which introduces a level of subjectivity. Zamora and Khan will work with collaborators from Vanderbilt University School of Engineering to develop a novel metric called the Clutch Proficiency Index (CPI) to objectively measure the skill level of surgical trainees.
Engaging the clutch when using a robot allows a surgeon to efficiently toggle between instrument tips and can also temporarily disconnect an instrument from the surgical console to allow the surgeon to safely reposition their hands without affecting the instruments in the operative field.
“Successful use of the clutch function is vital for the precise and safe movement of tools during robot-assisted surgeries as well as the well-being of the surgeon, particularly during complex or lengthy procedures,” said Zamora. “This critical skill is currently not assessed in a standardized manner as individuals train to use these robots in the operating room. With our tool, we hope to change that not just at VUMC, but at all institutions where surgical robots are being used with increasing frequency.”
A pilot study using a robot training platform will collect various metrics of 10 surgical residents and 10 faculty surgeons as they perform a bowel anastomosis (rejoining of bowel segments). The data will be compared to the results of surgeons who are experts in robot-assisted surgeries (more than 50 robot-assisted cases as the primary surgeon).
A validation study will then be conducted with blinded, independent reviewers grading simulated robot-assisted surgery performance using existing measurement tools, then using the CPI.
“Using robots in the operating room has grown to the point that it now impacts every field of surgery, with an estimated million robotic surgeries performed annually in the United States,” said Khan. “There is no standardized curriculum for training residents, fellows and other surgeons who wish to gain these skills.
“In our experience, proficiency with using the clutch during robot-assisted procedures is critical, ideally to the point that it becomes second nature. Developing and validating a tool to assess skills related to clutch use will give us a much better picture of a surgeon’s proficiency with the robot. In addition to bolstering confidence, this should ultimately improve the efficiency and safety of robot-assisted procedures.”
The ASE Giant Robot Award supports research projects that focus on robotic surgery research questions including curriculum design, training programs, assessment metrics and patient outcomes.
