A prospective observational study on minimally invasive surgery skill acquisition across novice levels

Purpose Evaluating the learning curve (LC) in surgical training is complex, as multiple factors influence skills acquisition. Among these, the impact of new technology might be the most critical. Few studies have assessed how new technology can influence LC, especially in novices with no surgical experience. Methods A prospective observational or interventional study was performed at an international minimally invasive training center from August 22nd to 26th 2022 . Two different groups of novices (medical vs. non-medical) were compared to assess how medical background could have an impact on performing laparoscopic and robotic tasks. Both groups were evaluated by performing a standardized set of validated simulation tasks: the Laparoscopic Assessment Skills Training Testing method (LASTT) and the advanced peg transfer task on four different robotic platforms (DaVinci X and Si, Versius CMR and Hugo ™ RAS System). Performance was graded using the validated Global Operative Assessment of Laparoscopic Skills (GOALS) Score System for laparoscopic and the Global Evaluative Assessment of Robotic Skills (GEARS) Score System. The main outcome measure was the ability to complete the exercises in the required times across novice groups. Results Thirteen medical and fourteen non-medical novices participated. The medical group performed significantly better in all LASTT exercises, reaching higher GOALS in-depth perception ( p = 0.008), bimanual dexterity ( p = 0.008), and efficiency ( p = 0.021). There were no significant differences across groups for time to task completion, depth perception, bimanual dexterity, autonomy, or robotic control on any robotic platform. Conclusion While medical students were more skilled in laparoscopy, no differences were found between groups on robotic platforms. Robotics democratized skills acquisition with a more predictable LC independent of medical experience.