Robotic Simulation Training

Simulation is a critical tool in minimally invasive surgery and holds similar importance in robotic surgery. In this chapter, we review the current use and promise of simulation in robotic surgery. We begin with a review of pertinent concepts in simulation. Fidelity is the accuracy of a simulation in representing a real system. The setting of the simulation creates opportunities for and controls the parameters of the simulation. Computerization has revolutionized simulation and has led to the development of virtual reality simulators for surgical training. We then discuss various levels of simulation fidelity within practical and virtual reality. Practical models include suture boards, trainer boxes, exercises in room setup, basic console use, and in vitro and cadaveric models. Virtual reality includes visual and auditory immersion which has introduced many new tools and opportunities for robotic surgical educators, researchers, and trainees. Finally, we review assessment tools used by educators to objectively and subjectively evaluate learners in simulation-based curricula and to evaluate the simulations themselves.