2023 General Surgery Presentations

K Stransky, MD1; C Tallant, MD2; P Liacouras, PhD1; W B Sweeney, MD, FACS1; B R Franklin, MD, MHPE, FACS1; 1Walter Reed National Military Medical Center; 2Naval Medical Center Portsmouth

Introduction: Ventral hernia repair is a common procedure performed by general surgeons, with approximately 350,000 performed each year in the United States.  Over the last decade, robotic ventral hernia repairs (rVHR) have increased 45-fold as robotic-assisted surgery becomes more prevalent.  Simulation is vital for robotic skills acquisition; however, a realistic rVHR training platform does not currently exist.  The goal of this study is to evaluate a novel abdominal wall model's ability to assess the skills required to perform a robotic assisted ventral hernia repair.

Methods: Using our previously created abdominal wall surgical skills operative model (AWSSOM), we created a platform for robotic ventral hernia and abdominal wall reconstruction procedures via an iterative process.  Next, we will evaluate the validity of the model as a simulation tool for rVHR with performance testing.  Participants of different levels of training will be recruited to perform a primary fascial closure using the Da Vinci platform. The data collected will be analyzed to compare the performance of participants based on robotic experience from novice to adept in rVHR.  Parameters for evaluation will include facility of camera and arm movement, suture technique, time to completion, and adequacy of fascial closure.

Results: The lack of simulation platforms for rVHR led to adaptation of the AWSSOM for training using a robotic approach. Prior to the creation of a novel curriculum, the model is being tested to determine if it can discriminate between varying levels of robotic hernia repair experience. Data is forthcoming and will determine if there is a relationship between rVHR experience and overall performance using the model.

Conclusions: The current simulation platforms for robotic general surgery training do not include a virtual or tissue model for ventral hernia repair.  Our model for rVHR is undergoing validity testing and shows promise as an option for rVHR simulation training. These data will be used toward the development of a comprehensive curriculum for resident robotic simulation training.