Breaking down the silos of artificial intelligence in surgery: glossary of terms.

Background: The literature on artificial intelligence (AI) in surgery has advanced rapidly during the past few years. However, the published studies on AI are mostly reported by computer scientists using their own jargon which is unfamiliar to surgeons.

Methods: A literature search was conducted in using PubMed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.

5G in Healthcare: From COVID-19 to Future Challenges.

Worldwide up to May 2022 there have been 515 million cases of COVID-19 infection and over 6 million deaths. The World Health Organization estimated that 115,000 healthcare workers died from COVID-19 from January 2020 to May 2021. This toll on human lives prompted this review on 5G based networking primarily on major components of healthcare delivery: diagnosis, patient monitoring, contact tracing, diagnostic imaging tests, vaccines distribution, emergency medical services, telesurgery and robot-assisted tele-ultrasound.

5G Use in Healthcare: The Future is Present.

Background: Most healthcare providers are unaware of the extraordinary opportunities for implementation in healthcare which can be enabled by 5G wireless networks. 5G created enormous opportunities for a myriad of new technologies, resulting in an integrated through 5G 'ecosystem'. Although the new opportunities in healthcare are immense, medicine is slow to change, as manifest by the paucity of new, innovative applications based upon this ecosystem.

A systematic review on artificial intelligence in robot-assisted surgery.

Background: Despite the extensive published literature on the significant potential of artificial intelligence (AI) there are no reports on its efficacy in improving patient safety in robot-assisted surgery (RAS). The purposes of this work are to systematically review the published literature on AI in RAS, and to identify and discuss current limitations and challenges.

Materials And Methods: A literature search was conducted on PubMed, Web of Science, Scopus, and IEEExplore according to PRISMA 2020 statement.

Scientific Literature and Evaluation Metrics: Impact Factor, Usage Metrics, and Altmetrics.

Evaluating the quality of a scientific article has proven to be an elusive task. The most widely used bibliometric value currently used for this purpose, the journal impact factor, was not originally designed to determine the quality of research in a scientific article. Nevertheless, it has morphed into a surrogate to delineate the quality of a journal and even to represent the quality of individual articles in that that journal.

Utilising an Accelerated Delphi Process to Develop Guidance and Protocols for Telepresence Applications in Remote Robotic Surgery Training.

Context: The role of robot-assisted surgery continues to expand at a time when trainers and proctors have travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic.

Objective: To provide guidance on setting up and running an optimised telementoring service that can be integrated into current validated curricula. We define a standardised approach to training candidates in skill acquisition via telepresence technologies.

Expert Consensus Recommendations for Robotic Surgery Credentialing.

Objective: To define criteria for robotic credentialing using expert consensus.

Background: A recent review of institutional robotic credentialing policies identified significant variability and determined current policies are largely inadequate to ensure surgeon proficiency and may threaten patient safety.

Methods: Twenty-eight national robotic surgery experts were invited to participate in a consensus conference.

Development and validation of metric-based-training to proficiency simulation curriculum for upper gastrointestinal endoscopy using a novel assessment checklist.

Background/aims: : This study aimed to design a structured simulation training curriculum for upper endoscopy and validate a new assessment checklist.

Materials And Methods: A proficiency-based progression stepwise curriculum was developed consisting of didactic, technical and non-technical components using a virtual reality simulator (VRS). It focused on: scope navigation, anatomical landmarks identification, mucosal inspection, retro-flexion, pathology identification, and targeting biopsy.

Proving the Effectiveness of the Fundamentals of Robotic Surgery (FRS) Skills Curriculum: A Single-blinded, Multispecialty, Multi-institutional Randomized Control Trial.

Objective: To demonstrate the noninferiority of the fundamentals of robotic surgery (FRS) skills curriculum over current training paradigms and identify an ideal training platform.

Summary Background Data: There is currently no validated, uniformly accepted curriculum for training in robotic surgery skills.

Methods: Single-blinded parallel-group randomized trial at 12 international American College of Surgeons (ACS) Accredited Education Institutes (AEI).

Demonstrating the effectiveness of the fundamentals of robotic surgery (FRS) curriculum on the RobotiX Mentor Virtual Reality Simulation Platform.

Fundamentals of robotic surgery (FRS) is a proficiency-based progression curriculum developed by robotic surgery experts from multiple specialty areas to address gaps in existing robotic surgery training curricula. The RobotiX Mentor is a virtual reality training platform for robotic surgery. Our aims were to determine if robotic surgery novices would demonstrate improved technical skills after completing FRS training on the RobotiX Mentor, and to compare the effectiveness of FRS across training platforms.

Orsi Consensus Meeting on European Robotic Training (OCERT): Results from the First Multispecialty Consensus Meeting on Training in Robot-assisted Surgery.

To improve patient outcomes in robotic surgery, robotic training and education need to be modernised and augmented. The skills and performance levels of trainees need to be objectively assessed before they operate on real patients. The main goal of the first Orsi Consensus Meeting on European Robotic Training (OCERT) was to establish the opinions of experts from different scientific societies on standardised robotic training pathways and training methodology.

Utilising the Delphi Process to Develop a Proficiency-based Progression Train-the-trainer Course for Robotic Surgery Training.

Context: As the role of robot-assisted surgery continues to expand, development of standardised and validated training programmes is becoming increasingly important.

Objective: To provide guidance on an optimised "train-the-trainer" (TTT) structured educational programme for surgical trainers, in which delegates learn a standardised approach to training candidates in skill acquisition. We aim to describe a TTT course for robotic surgery based on the current published literature and to define the key elements within a TTT course by seeking consensus from an expert committee formed of key opinion leaders in training.

Origins of Robotic Surgery: From Skepticism to Standard of Care.

Background And Objectives: The uses of robotics in surgery were hypothesized as far back as 1967, but it took nearly 30 years and the nation's largest agency, the Department of Defense, in conjunction with innovative startups and established research agencies to complete the first fully functional multipurpose surgical robot. Currently, the most prominently available multipurpose robotic surgery system with US Food and Drug Administration approval is Intuitive Surgical Inc.'s da Vinci Surgical System, which is found in operating rooms across the globe.

Outlier experienced surgeon's performances impact on benchmark for technical surgical skills training.

Background: Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency.

Measuring Surgical Skills in Simulation-based Training.

Simulation-based surgical skills training addresses several concerns associated with the traditional apprenticeship model, including patient safety, efficient acquisition of complex skills, and cost. The surgical specialties already recognize the advantages of surgical training using simulation, and simulation-based methods are appearing in surgical education and assessment for board certification. The necessity of simulation-based methods in surgical education along with valid, objective, standardized techniques for measuring learned skills using simulators has become apparent.

Retention of Skills After Simulation-based Training in Orthopaedic Surgery.

Simulation-based surgical skills training has become essential in orthopaedic practice because of concerns about patient safety and an increase in technically challenging procedures. Surgical skills training in specifically designed simulation laboratories allows practice of procedures in a risk-free environment before they are performed in the operating room. The transferability of acquired skills to performance with patients is the most effective measure of the predictive validity of simulation-based training.

A stepwise model for simulation-based curriculum development for clinical skills, a modification of the six-step approach.

Background: Despite the rapid growth in the use of simulation in health professions education, courses vary considerably in quality. Many do not integrate efficiently into an overall school/program curriculum or conform to academic accreditation requirements. Moreover, some of the guidelines for simulation design are specialty specific.

Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study.

Background: Preoperative simulation warm-up has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized that a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors.

Study Design: In a 2-center randomized trial, 51 residents and experienced minimally invasive surgery faculty in General Surgery, Urology, and Gynecology underwent a validated robotic surgery proficiency curriculum on a VR robotic simulator and on the da Vinci surgical robot (Intuitive Surgical Inc).

Future of robotic surgery.

In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade.

Prospective, randomized assessment of transfer of training (ToT) and transfer effectiveness ratio (TER) of virtual reality simulation training for laparoscopic skill acquisition.

Objectives: We assessed the effectiveness of ToT from VR laparoscopic simulation training in 2 studies. In a second study, we also assessed the TER. ToT is a detectable performance improvement between equivalent groups, and TER is the observed percentage performance differences between 2 matched groups carrying out the same task but with 1 group pretrained on VR simulation.