Background

The Advanced Training in Laparoscopic Suturing (ATLAS) curriculum teaches and assesses laparoscopic suturing. This study aimed to modify it for a robotic platform (R-ATLAS) and establish proficiency benchmarks.

Methods

The tasks and scoring protocol were maintained according to the laparoscopic model with exception of: a robotic dome box was used with 0 deg camera. A smartphone was used to record and analyze video. Each robotic surgeon performed five consecutive repetitions on all six ATLAS tasks and the performances were video recorded. A single ATLAS video grading expert rated each repetition. After each task, the subjects completed a NASA Task Load Index (TLX) scale (1-126 with higher meaning greater workload) to measure the task workload. Outliers (+2 standard deviations [SD]) were removed from the data sets and trimmed means and the new SD were used to create proficiency benchmarks.

Results

Four robotic surgeons completed the study. See Table 1.Conclusions:In this study, we demonstrated the feasibility of modifying the ATLAS laparoscopic curriculum for robotic advanced suturing and established performance benchmarks. Based on these results, it will be possible to objectively compare laparoscopic and robotic suturing skill, learning curve, and cognitive load.