Effect of virtual reality versus dry lab training on technical skills in robotic surgical simulation: a systematic review and meta-analysis
- 1Department of Surgery, Surgical Oncology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX USA
- 2Simulation Center, University of Texas Southwestern Medical Center, Dallas, TX USA
- 3Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390 USA
Abstract
Background: Virtual reality (VR) and dry lab (DL) platforms are widely used for robotic surgery training, yet their comparative effectiveness remains uncertain, particularly for suturing skills.
Methods: A systematic review of controlled studies comparing VR with physical robotic simulation was conducted; meta-analysis was restricted to VR versus DL studies. PubMed, Embase, MEDLINE, and the Cochrane Library were searched. The primary outcome was post-training technical performance; task completion time was secondary. Pooled standardized mean differences (SMD) or mean differences (MD) with 95% CI were calculated using random-effects models.
Results: Ten studies (333 trainees) were included in the qualitative synthesis, and six (168 participants) in the quantitative analysis. DL training showed significantly higher post-test technical performance (SMD – 0.43; 95% CI – 0.74 to – 0.12). In RCTs (n = 89), the difference was not significant (SMD – 0.15; 95% CI – 0.57 to 0.27). Fixed-time curricula favored DL (SMD – 0.51; 95% CI – 0.96 to – 0.05), whereas proficiency-based progression showed no difference. Task completion time was similar between modalities (MD 0.14; 95% CI – 0.43 to 0.70).
Conclusions: DL training was associated with higher post-test technical performance overall, but not in the RCT-only analysis; task completion time was similar between modalities. Both approaches may have complementary roles depending on curriculum, task, and trainee characteristics.
Graphical abstract:
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00464-026-13459-0.
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BibTeX
@article{castilloflores2026effect,
title = {{Effect of virtual reality versus dry lab training on technical skills in robotic surgical simulation: a systematic review and meta-analysis}},
author = {Samy Castillo-Flores and Ricardo E. Nunez-Rocha and Andres A. Abreu and Zachary A. Whitham and Gilbert Z. Murimwa and Morgan F. Pettigrew and Ofelia Negrete-Vasquez and Ganesh Sankaranarayanan and Angela A. Guzzetta and Daniel J. Scott and Herbert J. Zeh and Patricio M. Polanco},
journal = {Surgical Endoscopy},
year = {2026},
month = oct,
doi = {10.1007/s00464-026-13459-0},
url = {https://doi.org/10.1007/s00464-026-13459-0},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Effect of virtual reality versus dry lab training on technical skills in robotic surgical simulation: a systematic review and meta-analysis
AU - Samy Castillo-Flores
AU - Ricardo E. Nunez-Rocha
AU - Andres A. Abreu
AU - Zachary A. Whitham
AU - Gilbert Z. Murimwa
AU - Morgan F. Pettigrew
AU - Ofelia Negrete-Vasquez
AU - Ganesh Sankaranarayanan
AU - Angela A. Guzzetta
AU - Daniel J. Scott
AU - Herbert J. Zeh
AU - Patricio M. Polanco
PY - 2026
DA - 2026/10/08
JO - Surgical Endoscopy
DO - 10.1007/s00464-026-13459-0
UR - https://doi.org/10.1007/s00464-026-13459-0
AB - Background: Virtual reality (VR) and dry lab (DL) platforms are widely used for robotic surgery training, yet their comparative effectiveness remains uncertain, particularly for suturing skills. Methods: A systematic review of controlled studies comparing VR with physical robotic simulation was conducted; meta-analysis was restricted to VR versus DL studies. PubMed, Embase, MEDLINE, and the Cochrane Library were searched. The primary outcome was post-training technical performance; task completion time was secondary. Pooled standardized mean differences (SMD) or mean differences (MD) with 95% CI were calculated using random-effects models. Results: Ten studies (333 trainees) were included in the qualitative synthesis, and six (168 participants) in the quantitative analysis. DL training showed significantly higher post-test technical performance (SMD – 0.43; 95% CI – 0.74 to – 0.12). In RCTs (n = 89), the difference was not significant (SMD – 0.15; 95% CI – 0.57 to 0.27). Fixed-time curricula favored DL (SMD – 0.51; 95% CI – 0.96 to – 0.05), whereas proficiency-based progression showed no difference. Task completion time was similar between modalities (MD 0.14; 95% CI – 0.43 to 0.70). Conclusions: DL training was associated with higher post-test technical performance overall, but not in the RCT-only analysis; task completion time was similar between modalities. Both approaches may have complementary roles depending on curriculum, task, and trainee characteristics. Graphical abstract: Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00464-026-13459-0.
SN - 0930-2794
SN - 1432-2218
ER -