Enhancing fundamental robot-assisted surgical proficiency by using a portable virtual simulator.

BACKGROUND The development of a virtual reality (VR) training platform provides an affordable interface. The learning effect of VR and the capability of skill transfer from the VR environment to clinical tasks require more investigation. METHODS Here, 14 medical students performed 2 fundamental surgical tasks-bimanual carrying (BC) and peg transfer (PT)-in actual and virtual environments. Participants in the VR group received VR training, whereas participants in the control group played a 3D game. The learning effect was examined by comparing kinematics between pretraining and posttraining in the da Vinci Surgical System. Differences between VR and playing the 3D game were also examined. RESULTS Those who were trained with the VR simulator had significantly better performance in both actual PT (P = .002) and BC (P < .001) tasks. The time to task completion and the total distance traveled were significantly decreased in both surgical tasks in the VR group compared with the 3D game group. However, playing the 3D game showed no significant enhancement of fundamental surgical skills in the actual PT task. The difference between pretraining and posttraining was significantly larger in the VR group than in the 3D game group in both the time to task completion (P = .002) and the total distance traveled (P = .027) for the actual PT task. Participants who played the 3D game seemed to perform even worse in posttraining. CONCLUSIONS Training with the portable VR simulator improved robot-assisted surgical skill proficiency in comparison to playing a 3D game.