USC Keck tests data recorder to measure robotic surgery performance

USC’s Keck School of Medicine has successfully used a data recorder to evaluate surgeon performance during prostate cancer surgery.

By doing that, it was able to create an objective and standardized process for training surgeons, according to the findings of a study, published in The Journal of Urology, involving data recorded from 70 surgeries involving the reconstruction step of robotic radical prostatectomy, which accounts for 87 percent of prostate cancer surgeries in the United States.

“Although robotic surgery is a widely adopted minimally invasive option for treating prostate cancer, standardized training for it doesn’t exist yet,” says Andrew Hung, MD, study co-author and assistant professor of clinical urology at Keck. “To create a methodical, streamlined training tutorial for this main reconstruction step of the prostate surgery, we relied on automated performance metrics and observation to objectively measure surgeon performance.”

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Andrew Hung, MD

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The recorder, called the dVLogger made by Intuitive Surgical, attaches to the vendor’s da Vinci Surgical System, a robotic surgery platform approved by the Food and Drug Administration, and records both video and movement data.

“This is a research tool—it’s not a product that’s on the market,” notes Hung. “It’s a recording device created by the manufacturer’s medical research team. We work in collaboration with them. What it records is the robot system data as well as synchronized video.”

Keck has been using the dVLogger since August 2016 during robotic-assisted radical prostatectomy procedures, providing the ability to differentiate between novice and expert surgeons. In fact, the study revealed that expert surgeons outperformed novices in completion time, instrument movement efficiency and camera manipulation. In addition, expert surgeons had fewer needle-driving attempts and less tissue trauma.

“What we tried to accomplish is creating automated performance metrics for surgeons to identify where their strengths and weaknesses lie,” says Hung.

“Automated performance metrics can distinguish surgeon expertise during vesicourethral anastomosis,” concluded the study’s authors. “The expert vesicourethral anastomosis technique was associated with more efficient movement and less tissue trauma. Standardizing robotic vesicourethral anastomosis and using a methodically developed tutorial may help improve robotic surgical training.”

At Keck, Hung and his colleagues are testing the efficacy of the tutorial with a group of medical students in the research lab. Ultimately, they hope their approach to developing this training tutorial could someday be applied to any procedure in any kind of robotic operation.

“While there is no single perfect way to do a perfect operation, creating a standardized method for robotic surgery training provides surgeons a common training ground,” Hung adds.

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