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Establishing objective benchmarks in robotic virtual reality simulation at the level of a competent surgeon using the RobotiX Mentor simulator
  1. William Watkinson1,
  2. Nicholas Raison2,
  3. Takashige Abe2,
  4. Patrick Harrison1,
  5. Shamim Khan2,
  6. Henk Van der Poel3,
  7. Prokar Dasgupta2,
  8. Kamran Ahmed2
  1. 1 King’s College London, London, UK
  2. 2 Division of Transplantation Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King’s College London, London, UK
  3. 3 Netherlands Cancer Institute, Amsterdam, The Netherlands
  1. Correspondence to Nicholas Raison, Division of Transplantation Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King’s College London, London WC2R 2LS, UK; nicholas.raison{at}


Background To establish objective benchmarks at the level of a competent robotic surgeon across different exercises and metrics for the RobotiX Mentor virtual reality (VR) simulator suitable for use within a robotic surgical training curriculum.

Methods This retrospective observational study analysed results from multiple data sources, all of which used the RobotiX Mentor VR simulator. 123 participants with varying experience from novice to expert completed the exercises. Competency was established as the 25th centile of the mean advanced intermediate score. Three basic skill exercises and two advanced skill exercises were used.

Setting King’s College London.

Participants 84 Novice, 26 beginner intermediates, 9 advanced intermediates and 4 experts were used in this retrospective observational study.

Results Objective benchmarks derived from the 25th centile of the mean scores of the advanced intermediates provided suitably challenging yet also achievable targets for training surgeons. The disparity in scores was greatest for the advanced exercises. Novice surgeons are able to achieve the benchmarks across all exercises in the majority of metrics.

Conclusion We have successfully created this proof-of-concept study, which requires validation in a larger cohort. Objective benchmarks obtained from the 25th centile of the mean scores of advanced intermediates provide clinically relevant benchmarks at the standard of a competent robotic surgeon that are challenging yet also attainable. That can be used within a VR training curriculum allowing participants to track and monitor their progress in a structured and progressional manner through five exercises. Providing clearly defined targets, ensuring that a universal training standard has been achieved across training surgeons.

  • robotic
  • simulation
  • benchmark
  • surgical education
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  • Contributors KA, NR, PD, SK and HvdP contributed to study planning. WW, PH and TA contributed to data collection. NR and WW are responsible for the overall content. WW submitted the study.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health.

  • Competing interests NR acknowledges financial support from the Vattikuti Foundation. PH acknowledges financial support from the Royal College of Surgeons of England in the form of an Intercalated BSc research award. KA and PD acknowledge financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre-based Guy’s and St Thomas’s NHS Foundation trust. PD also acknowledges the support of the Medical Research Council Centre for Transplantation, London Deanery, London School of Surgery, Guy’s and St. Thomas’ Charity, European Union, Vattikuti Foundation and Olympus.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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