Advances and Challenges of Using Experimental Pigs in Da Vinci Surgical Robot Training

doi:10.12300/j.issn.1674-5817.2024.075

Abstract

Abstract:

Experimental pigs occupy a crucial position in life sciences research and have been indispensable in advancing the practical application of new clinical technologies and methods. The Da Vinci Surgical Robot System, developed by Intuitive Surgical in the United States, has been widely used across various surgical fields since its approval by the U.S. Food and Drug Administration (FDA) in 2000, and is highly esteemed for its precision and accuracy. With the continuous advancement of surgical robot technology, the skill requirements for medical professionals have also increased. Consequently, surgical skills training has become an essential component of ensuring both surgical safety and effectiveness. This article briefly reviews the current status of Da Vinci surgical robot training, both domestically and internationally, with a focus on the practical application of experimental pigs in domestic Da Vinci surgical robot training. It emphasizes that experimental pigs not only effectively simulate the human surgical environment, enabling trainees to practice in a safe and controlled setting, but also help accelerate the trainees' familiarity with and mastery of the surgical robot. This, in turn, significantly shortens the learning curve, enhances the precision and stability of surgical procedures, and reduces surgical risks. However, the use of experimental animals in surgical robot training also encounters challenges, including limitations caused by the differences between experimental animals and humans, potential ethical concerns, and public opinion pressures. In response to these challenges, the paper proposes suggestions such as improving and enforcing ethical regulations, as well as advancing the development of virtual reality (VR) and augmented reality (AR) technologies. These efforts aim to reduce reliance on experimental animals in surgical training while enhancing training effectiveness, thereby contributing to the innovation and development of Da Vinci surgical robot training models.

Key words: Experimental pigs, Surgical simulation, Da Vinci surgical robot, Ethics for laboratory animals, Virtual reality

CLC Number:

R-332

LIU Yishu,CAI Liping. Advances and Challenges of Using Experimental Pigs in Da Vinci Surgical Robot Training[J]. Laboratory Animal and Comparative Medicine, 2024, 44(6): 667-674. DOI: 10.12300/j.issn.1674-5817.2024.075.

Figures/Tables 2

Figure 1 Timeline of Da Vinci surgical robot surgeon training program

Figure 2 Illustrative stages of using experimental pigs for Da Vinci surgical robot trainingNote：A， Interface of theoretical course for Da Vinci surgical robot； B， Interface of continuous suture training module in SimNow computer simulation trainer； C， Performing setup and instrument installation training with Dry Lab abdominal model； D， Performing suture and knot-tying training with Dry Lab abdominal model； E， Interface of suturing and knot tying under endoscope； F， Interface of electric energy use under endoscope； G， Interface of blunt dissection under endoscope； H， Interface of vascular separation under endoscope.

References 26

1	BEN-OR S, NIFONG L W, CHITWOOD W R JR. Robotic surgical training[J]. Cancer J, 2013, 19(2):120-123. DOI: 10.1097/PPO.0b013e3182894887 .
2	RIVERO-MORENO Y, ECHEVARRIA S, VIDAL-VALDERRAMA C, et al. Robotic surgery: a comprehensive review of the literature and current trends[J]. Cureus, 2023, 15(7): e42370. DOI: 10.7759/cureus.42370 .
3	BRESLER L, PEREZ M, HUBERT J, et al. Residency training in robotic surgery: the role of simulation[J]. J Visc Surg, 2020, 157(3): S123-S129. DOI: 10.1016/j.jviscsurg.2020.03.006 .
4	FISHER R A, DASGUPTA P, MOTTRIE A, et al. An over-view of robot assisted surgery curricula and the status of their validation[J]. Int J Surg, 2015, 13:115-123. DOI: 10.1016/j.ijsu.2014.11.033 .
5	BUFFI N, VAN DER POEL H, GUAZZONI G, et al. Methods and priorities of robotic surgery training program[J]. Eur Urol, 2014, 65(1):1-2. DOI: 10.1016/j.eururo.2013.07.020 .
6	MUKHERJEE P, ROY S, GHOSH D, et al. Role of animal models in biomedical research: a review[J]. Lab Anim Res, 2022, 38(1):18. DOI: 10.1186/s42826-022-00128-1 .
7	RAISON N, POULSEN J, ABE T, et al. An evaluation of live porcine simulation training for robotic surgery[J]. J Robot Surg, 2021, 15(3):429-434. DOI: 10.1007/s11701-020-01113-3 .
8	Surgical Intuitive, Inc. Intuitive announces preliminary fourth quarter and full year 2023 results[EB/OL]. (2024-01-09)[2024-04-10]. https://investor. intuitivesurgical. com/news-releases/news-release-details/intuitive-announces-preliminary-fourthquarter-and-full-year-3..
9	NASSER KOTBY M, WAHBA H A, KAMAL E, et al. Animal model for training and improvement of the surgical skills in endolaryngeal microsurgery[J]. J Voice, 2012, 26(3):351-357. DOI: 10.1016/j.jvoice.2011.04.002 .
10	李建萍, 刘意抒, 蔡丽萍, 等. 达芬奇手术机器人国际培训中心建设[J]. 解放军医院管理杂志, 2017, 24(12):1156-1158. DOI: 10.16770/J.cnki.1008-9985.2017.12.016 .
	LI J P, LIU Y S, CAI L P, et al. Construction of the da vinci surgical robot international training center[J]. Hosp Adm J Chin People's Liberation Army, 2017, 24(12):1156-1158. DOI: 10.16770/J.cnki.1008-9985.2017.12.016 .
11	WALTERS E M, WELLS K D, BRYDA E C, et al. Swine models, genomic tools and services to enhance our understanding of human health and diseases[J]. Lab Anim, 2017, 46(4):167-172. DOI: 10.1038/laban.1215 .
12	WANG Y, CHEN G, PAN D, et al. Pig-to-human kidney xenotransplants using genetically modified minipigs[J]. Cell Rep Med, 2024, 5(10):101744. DOI: 10.1016/J.XCRM. 2024. 101744 .
13	TIONG H Y, GOH B Y S, CHIONG E, et al. Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis[J]. J Robot Surg, 2018, 12(4):693-698. DOI: 10.1007/s11701-018-0806-5 .
14	KAJIWARA N, KAKIHANA M, USUDA J, et al. Training in robotic surgery using the da Vinci^® surgical system for left pneumonectomy and lymph node dissection in an animal model[J]. Ann Thorac Cardiovasc Surg, 2011, 17(5):446-453. DOI: 10.5761/atcs.oa.10.01613 .
15	KASABWALA K, GOUELI R, CULLIGAN P J. A live porcine model for robotic sacrocolpopexy training[J]. Int Urogynecol J, 2019, 30(8):1371-1375. DOI: 10.1007/s00192-019-03936-7 .
16	LI D W, LIU Z X, ZANG Y, et al. Video laryngoscope-guided urethral catheterization in female minipigs[J]. Lab Anim. 2022, 56(5):446-453. DOI: 10.1177/00236772221092933 .
17	刘意抒, 赵善民, 蔡丽萍. 不同麻醉通气方法在胸外科微创手术培训中的应用与比较[J]. 实验动物与比较医学, 2024, 44(1):97-104. DOI: 10.12300/j.issn.1674-5817.2023.135 .
	LIU Y S, ZHAO S M, CAI L P. Application and comparison of different anesthetic ventilation methods in minimally invasive thoracic surgery training[J]. Lab Anim Comp Med, 2024, 44(1):97-104. DOI: 10.12300/j.issn.1674-5817.2023.135 .
18	贺争鸣, 陈洪岩, 陈振文, 等. 基于科研范式变革的实验动物资源创新发展[J]. 实验动物科学, 2024, 41(1):84-88. DOI: 10.3969/j.issn.1006-6179.2024.01.015 .
	HE Z M, CHEN H Y, CHEN Z W, et al. Reflection on the innovation and development of laboratory animal resources based on the transformation of scientific research paradigm[J]. Lab Anim Sci, 2024, 41(1):84-88. DOI: 10.3969/j.issn.1006-6179.2024.01.015 .
19	RAISON N, HARRISON P, ABE T, et al. Procedural virtual reality simulation training for robotic surgery: a randomised controlled trial[J]. Surg Endosc, 2021, 35(12):6897-6902. DOI: 10.1007/s00464-020-08197-w .
20	FOTOUHI J, SONG T Y, MEHRFARD A, et al. Reflective-AR display: an interaction methodology for virtual-to-real alignment in medical robotics[J]. IEEE Robot Autom Lett, 2020, 5(2):2722-2729. DOI: 10.1109/LRA.2020.2972831 .
21	CULLIGAN P, GURSHUMOV E, LEWIS C, et al. Predictive validity of a training protocol using a robotic surgery simulator[J]. Female Pelvic Med Reconstr Surg, 2014, 20(1):48-51. DOI: 10.1097/SPV.0000000000000045 .
22	DELPECH P O, DANION J, ORIOT D, et al. SimLife a new model of simulation using a pulsated revascularized and reventilated cadaver for surgical education[J]. J Visc Surg, 2017, 154(1):15-20. DOI: 10.1016/j.jviscsurg.2016.06.006 .
23	DANION J, BREQUE C, ORIOT D, et al. SimLife^® technology in surgical training-a dynamic simulation model[J]. J Visc Surg, 2020, 157(3 ): S117-S122. DOI: 10.1016/j.jviscsurg. 2020.02.013 .
24	DANION J, DONATINI G, BREQUE C, et al. Bariatric surgical simulation: evaluation in a pilot study of SimLife, a new dynamic simulated body model[J]. Obes Surg, 2020, 30(11):4352-4358. DOI: 10.1007/s11695-020-04829-1 .
25	COSTELLO D M, HUNTINGTON I, BURKE G, et al. A review of simulation training and new 3D computer-generated synthetic organs for robotic surgery education[J]. J Robot Surg, 2022, 16(4):749-763. DOI: 10.1007/s11701-021-01302-8 .
26	张超超, 田雪松. 虚拟现实在实验动物行为分析中的应用进展[J]. 实验动物与比较医学, 2023, 43(1):73-78. DOI: 10.12300/j.issn.1674-5817.2022.078 .
	ZHANG C C, TIAN X S. Application of virtual reality in the behavior analysis of laboratory animal[J]. Lab Anim Comp Med, 2023, 43(1):73-78. DOI: 10.12300/j.issn.1674-5817.2022.078 .

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