Effectiveness and feasibility of short-course simulator training for robotic surgery novices - a randomized controlled trial (FastSim trial).

Objectives: As robot-assisted surgery (RAS) is on the rise, feasible and effective simulator training for surgical residents is needed. This study compares the effectiveness and feasibility of two compact simulator training protocols on the DaVinci skills simulator (dVSS) for preparing robotic surgery novices. Methods: In this randomized controlled trial, RAS novices were randomized 1:1 into a conventional group (Control), including four repetitions of five simulator exercises in two sessions, and a fast group (Fast), with two repetitions of the same five simulator exercises in a single training session. The primary endpoint was the mean efficiency score achieved in the final exercise. Results: Fifty-two participants (22 males) were randomized, 26 in each group. Forty-eight per cent were between 30 and 50 years old and most of the participants were residents (44.2 %) or consultants (42.3 %), 13.5 % were students. The primary endpoint results showed a mean efficiency score of 48.2 ± 26.7 (Fast) vs. 52.3 ± 30.4 (Control) in the intention-to-treat analysis (p=0.527). The most significant improvement in efficiency and penalty scores was observed between the 1st and 4th repetitions in the control group. Participants over 50 years old and consultants performed worse than younger participants, students and resident doctors. Participants interested in robotic surgery outperformed those with little or no interest. Conclusions: A training of 10-20 exercises on the dVSS with ascending levels is insufficient to succeed in complex simulation exercises but improves performance and motivation. These findings emphasize the need for tailored training programs and continuous skill development in robotic surgery.