Attendees at this year’s Annual EAU Congress are invited to demo the newest surgery simulator created by Mimic Technologies.
The new, portable system includes the same top training programs you’ll find on the full size dV-Trainer, such as Maestro AR with Prostatectomy Si and Prostatectomy Xi – yet the new FlexVR™ surgery simulator is more portable, storable, and flexible. It’s smaller, light weight size makes it easy to transport and ideal for training centers and robotic surgeons looking for a more personal training experience.
The annual EAU meeting is recognized for its live surgeries, state-of-the-art lectures, hands-on training, symposiums, and educational courses with the world’s top urologist, and is the perfect place to unveil a groundbreaking new surgery simulator.
Personal, Portable, Storable, Flexible, be among the first to see what’s inside FlexVR™ at this year’s EAU Congress.
Schedule a demo at EAU:
Phone: + 49 40 31795916
SAGES Attendees Invited for a First Look at a Revolutionary New Portable Training System for Robotic Surgery
In a world where robotic surgery is becoming more prevalent, Mimic is introducing the first simulator designed with mobility, flexibly, and storability in mind.
Ideal for training centers and robotic surgeons looking for a more personal training experience, the new FlexVR™ will be on display at this year’s SAGES, March 22-24, in Houston, Texas.
The annual meeting, designed to encourage communication and collaboration among the world’s top surgeons, is the perfect place to unveil a groundbreaking new technology that makes it easier for any robotic surgeon, from novice to experienced, to train in the privacy of their own home or office.
Supporting the same top training programs found on the full size dV-Trainer, the FlexVR™ is light in weight but not in power. In addition to the MSim psychomotor skills software and Maestro AR procedure-specific skills software, FlexVR™ also utilizes Mimic’s MScore administrative software allowing for personalized curriculum development and user proficiency tracking. MScore Portal allows all user data to be stored, backed up, and accessed in the cloud so that your program data is always at your fingertips.
Portable, Storable, Personal, Flexible, be among the first to see what’s inside FlexVR™ at this year’s SAGES. Schedule a demo now:
In a recent blog about components of a successful robotic surgery simulation program, team Training was listed as one of the important factors.
‘The study, Teaching Surgical Skills – Changes in the Wind, published in the New England Journal of Medicine by Dr. Richard Reznick, et al., stated, “Virtual reality has the potential to enhance surgical-team training as well as technical skills training. In aviation, teamwork training with simulation has been instrumental in reducing errors. The importance of teamwork in preventing medical error is well recognized, and simulator-based team training has been advocated as a possible preventive approach. Early research results have been promising.”‘
The ability to incorporate team training within a simulation training curricula ensures that the trainees will have well-rounded skills such as communication and movement coordination in addition to being proficient in operating the tool they are training for. So how, specifically, can you improve your robotics program with team training?
Mimic’s Xperience Team Trainer (XTT) is a haptic-enabled laparoscopic trainer that connects to the dV-Trainer, allowing both the first assistant the console surgeon to work together. Currently, the XTT ships with 24 different exercises, of which, 11 are laparoscopic only. These lap-only training exercises allow the first assistant to develop simple skills in areas such as object manipulation, suturing & knot tying, needle control, or in the use of energy and dissection.
The other 11 exercises included are meant to develop skills such as transfers and handoffs, retraction, or clip application and also include a team-training playground environment for those who want to have some fun and practice in a free-form space.
Amongst the available exercises for Mimic’s robotic surgery simulation, Pick and Place is definitely a favorite on the dV-Trainer, the da Vinci© Skills Simulator, and now on the XTT as well. Making this same exercise available on the XTT allows for skills to be tested in a laparoscopic environment as well as in a team mode. Doing the same exercise on both the robotic console and with laparoscopic tools helps to illustrate the differences between the two.
In addition, utilizing simulation training outside of the OR, the XTT allows for:
- Better OR Team Communication
When used together with Mimic’s dV-Trainer, the XTT helps to develop basic skills as it facilitates rehearsal of interaction between the console-side surgeon and the first assist. Learning to work together in both physical movement and verbal communication, in a safe virtual reality environment, helps surgical teams to develop confidence in their ability to work well together. Trainers who have used team training as part of their curriculum have noted that the debrief is often as important as the training exercise itself.
- Refinement of Laparoscopic Skills for the First Assistant
In addition to training together with the console-side surgeon, the first assistant can also practice psychomotor skills specific to laparoscopy using the XTT for lap-only exercises. While this is not intended as a standalone laparoscopic trainer, it will help the first assist develop confidence in their ability to work in this environment. It can also be used as a simple way to test an individual’s innate ability.
- Learning Port Placement and Training in Multiple Port Positions
Unfortunately, in the real world the first assistant is not always standing comfortably in relation to the patient. Given the position of the patient side cart and the robotic arms, the first assistant is not always in the most ideal position. The XTT can be adjusted to various different port positions that allow the first assistant to practice setting up the laparoscopic instruments to match realistic environments. These Port Placement exercises break down the complicated set up requirements of robotic surgery.
Click here to learn more about the XTT. Email info@MimicSimulation.com or call (800) 918-1670 to speak to someone at Mimic to learn more about how to maximize your investment in robotic surgery through simulation training.
Over the past few months we have talked frequently about the importance of acquiring proficiency in robotic surgery. Although this may have been evident to many, the term proficient has been based on the Dreyfus Model of Skill Acquisition. This model, developed in the 1980’s, focuses on how students acquire skills through formal instruction and practice. It was developed by the brothers, Stuart and Hubert Dreyfus, out of the University of California, Berkeley.
The diagram below is a simple representation of the Dreyfus model:
The critical factor is being able to determine where individuals sit on this progression and what are the real objective boundaries between the different skill levels.
The concept of proficiency was taken up by surgeons when beginning to learn laparoscopic surgery and incorporated into the Fundamentals of Laparoscopic Surgery (FLS) where a proficiency level of 2 consecutive and 10 non-consecutive passes have to be achieved before certification is reached.
The da Vinci® surgical system is currently the main player in the computer-assisted surgical market. Over 3M procedures have been done with the system, of which some 650,000 were in the last 12 months. What does it take to become proficient at using a da Vinci system?
First and foremost, it is important to realize that surgery is a team activity and that while the role of the surgeon is vital in the ensuring the best outcomes for the patient, the surgeon can only do so if supported by a highly skilled OR team.
The da Vinci System was designed around three key principles, 3D visualization, dexterity, and control. This essentially means that the system allows the surgeon to see and move within the operative field in a way that they were not able to beforehand while building in safe guards to ensure patients could not be inadvertently harmed.
To achieve this, the surgeon is placed on a console outside the operative field where they can control a combination of instruments using their hands and their feet. Instruments are changed by an assistant who will replace the required instrument at the correct time.
When training to use the da Vinci system, it is not only important to ensure that the surgeon is proficient at controlling the system itself but that the whole team is also comfortable with working in this new environment. What does take some time getting used to is the fact that the team leader is no longer at the bed side but is now sitting apart outside of the sterile field immersed in the console. Given the high quality of the image, they can easily become immersed in the operative field.
How do hospitals therefore ensure that their surgeons and teams are proficient and ready to perform robotic surgery? Also how do they make sure that they after their initial training they are staying up to speed with evolutions in the technology and gaining enough exposure to the system?
The table below shows a typical case distribution by surgeon over a three year period. The X axis shows the average number of cases and the Y axis represents each surgeon ranked from lowest to highest volume.
Many hospitals will typically use a minimum case volume per year to decide whether or not a surgeon should maintain privileges on a robotic system. However, looking at the distribution of cases, can the number of cases alone really be used to determine whether or not a surgeon and team are performing as advanced beginners, competent users, or are really proficient?
Thanks to its 10 years of experience in the training of surgeons and teams to run effective robotic surgical programs, Mimic has the experience to help hospitals with this issue. MimicMED’s Consultancy Services can help organizations set their thresholds to distinguish between the different skill levels, evaluate their surgical staff, and see where they currently sit on the continuum as well as develop and implement training programs to ensure overall objectives are met.
Like any new technology, a lot of focus has been placed on ensuring that new users of robotic surgery are adequately trained. Simulation has had a large part to play with this. As the technology has become more mainstream, training requirements have moved from not only training existing surgeons but to ensuring that residents and fellows develop the required skill levels to ensure that they can adapt to the new technologies used in their practice.
Earlier this year we discussed a paper published by the EAU on their curriculum aimed at ensuring that fellows followed a clear curriculum at the end of which they would be deemed to be safe and competent to operate on patients independently. As with many ways of teaching surgery, the procedure is broken into specific steps that the trainee must master before being allowed to carry the whole procedure.
A typical prostatectomy is divided into the 7 following steps: bladder takedown, endopelvic fascia, bladder neck, seminal vesicle/vas deferens, pedicle/nerve sparing, apex, and anastomosis. Typically a trainee will be given a maximum time, of say 30 minutes,to complete one of these tasks during a procedure. Once they have shown that they have mastered the tasks, they will be allowed to move onto another task and eventually to the whole procedure. This is obviously easier to accomplish on parts of the anatomy and procedures that can be standardized.
Until recently, there have not been many studies looking into this practice to see what the potential patient impact could be comparing when a surgery was performed by just the one attending surgeon to one where parts of the case had been handed over to the resident.
Dr. Thiel from the Mayo Clinic in Jacksonville, Florida, has published a paper on just this topic comparing 140 cases where just an attending was involved in the surgery to 232 cases when a resident took over part of the case.
There were no differences in some key clinical outcomes such as positive margins, length of stay, catheter days, readmissions or re-operations when comparing surgeon only to resident –involved cases. There was, however, a difference seen in mean operative time between procedures that were surgeon only cases vs. resident involved (190.4 Min vs. 206.4 Min, P= 0.003)
The researchers also noted that residents were more likely to be involved with at least 1 procedural step after the purchase of the dV-Trainer.
Mimic believes in this way of training residents which is why the Maestro AR set of procedural curricula we have developed are divided into the procedural steps that a resident will be required to learn. We have been able to marry narrated 3D video content with didactic exercises that allow for a student’s ability to be tested. At the appropriate point, the correct psychomotor skill is inserted to make sure that the student can match the skills required for the procedural step.
Mimic currently has the following available:
- Right Partial Nephrectomy, Dr. Indibir Gill, USC
- Hysterectomy, Dr. Arnold Advincula, Columbia University
- Inguinal Hernia Repair, Dr. Rick Low, John C. Lincoln Hospital
- Prostatectomy (Si), Dr. Henk van der Poel, Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute in Amsterdam
- Prostatectomy (Xi), Dr. Vip Patel, Florida Hospital
- In Development for Q4 ‘16 Release:
- Lower Anterior Resection, Dr. Eduardo Parra, Florida Hospital