Single Session of Robotic Human Cadaver Training: The Immediate Impact on Urology Residents in a Teaching Hospital

Introduction and objective: To evaluate the immediate impact of robotic human cadaver training on the confidence with robotic surgery among urology residents. Methods: After a preliminary survey assessing baseline skills, our institution's urology residents attended a single session of robotic training on fresh-frozen human cadavers, supervised by staff urologists. Post-training, both the residents and the supervisors were administered a survey querying the improvement of robotic skills and the sentiments toward the cadaver laboratory compared with alternative trainings (answers were given by Likert scale: 1 = negative/5 = positive). Results: Twenty-two residents and five supervisors completed the surveys. Median residents' age was 32 years (IQR 29-33). Median year of residency was 4 (IQR 3-6). One hundred percent of the residents were familiar with robotics (86.4% had previous experience as bedside assistant; 90.9% have performed a median of 15 procedures at console). Post-training the residents evaluated their confidence with port placement and docking, EndoWrist® manipulation, Camera and Clutching, Fourth Arm Integration, and Needle Control and Driving with median scores of 4 (IQR 4-5), 4 (IQR 4-5), 4 (IQR 4-5), 4 (IQR 4-4), and 4 (IQR 3-4), with significant perceived improvement in all skills (P < .045). Almost all of them (86.4%) rated the cadaver training 5. When asked about the superiority of human cadaver training with respect to the virtual simulator and the pig laboratory, residents gave median scores of 5 (IQR 5-5) and 4 (IQR 3-5). At univariate analysis, increased experience with robotics was found to be inversely associated with improvement in the "camera and clutching" skill (P < .048). The supervisors felt that human cadaver training was effective in improving the residents' robotic skills (median answer of 5, IQR 4-5). Conclusions: Human cadaver robotic training demonstrated great acceptability among both the residents and the supervisors. It allowed for immediate improvement of the residents' robotic skills.