Transition effects from laparocscopic to robotic surgery skills in small cavities

  • S. Moncayo
  • R. Compagnon
  • F. Caire
  • C. Grosos
  • C. Bahans
  • P. Ilhero
  • L. Fourcade
  • Q. BallouheyEmail author
Original Article


Conventional laparoscopic surgery (LS) is being challenged by the ever-increasing use of robotic surgery (RS) to perform reconstructive procedures. The purpose of this study was to assess the acquisition of skills in both techniques and the potential transfer of skills from one technique to the other when restricted spaces are involved. A preclinical randomized crossover study design was implemented. Twelve subjects performed two different reproducible drill procedures: “Thread the Ring” (TR) and “Transfer the Plot” (TP). To assess surgical proficiency in confined workspaces, these exercises were performed with LS and RS technology in a pediatric laparoscopic surgery (PLS) simulator. Each performance was recorded and evaluated by two reviewers using objective structured assessment of technical skills (OSATS). The times to complete the TP and the TR procedure were significantly shorter with RS compared to LS (64 s vs. 319 s; p < 0.0001 for both TP and TR). A significant transfer effect of skills between LS and RS was noted for the TP exercise (p = 0.006). The percentage improvement was greater overall with LS, meaning a higher number of trials were required to adequately master the procedure. This study demonstrated that RS performed significantly better compared to LS on pediatric simulation devices. A transfer effect was identified from LS to RS exclusively. The learning curves showed that progression was definitely longer with LS. These results, indicate that novice surgeons should be encouraged to persist with learning LS, and they support the use of a pediatric robotic simulation device.


Learning curve Robotic surgery Transfer effect Simulation 



Robotic surgery


Laparoscopic surgery


Pediatric laparoscopic surgery



The authors thank R. Peymirat for his technical assistance with image editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Service de Chirurgie Viscérale PédiatriqueHôpital des EnfantsLimoges CedexFrance
  2. 2.Service de NeurochirurgieHôpital DupuytrenLimoges CedexFrance

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