Virtual reality simulations in robotic surgery training: a systematic review and meta-analysis

Objective: To compare VR simulations with other training methods regarding improvements in objective assessment scores and task completion times.

Method: A database search was conducted on 20 May 2024 across Central, MEDLINE, EMBASE, Web of Science, and Scopus. Included were randomised controlled trials comparing VR simulations to other training methods, assessing objective scores and task times. The Risk of Bias-2 tool was used for bias assessment.

Results: Eighteen studies were included. VR significantly improved objective scores (n = 339, SMD 1.04, 95% CI 0.40-1.69, P = 0.002) and reduced task completion times (n = 357, SMD of -1.08, 95% CI of as - 2.05 to - 0.12, P = 0.03) compared to no additional training. VR was as effective as dry lab training for improving scores (n = 213, SMD -0.47, 95% CI - 1.34 to 0.41, P = 0.30) and task times (n = 98, SMD - 0.37, 95% CI - 1.51 to 0.78, P = 0.53). However, one study found wet lab training significantly reduced task times compared to VR (n = 20, SMD of 1.7, 95% CI of 0.65-2.76, P = 0.002). No significant differences were found when VR alone was compared to VR with expert advice.

Conclusion: VR is more effective than no additional training and is as effective as dry lab training in robotic skill acquisitions. Therefore, VR is effective in enhancing robotic surgery skills and warrants an expanded role in surgical training programmes.