{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:41:00Z","timestamp":1774946460597,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T00:00:00Z","timestamp":1498608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To develop and evaluate a high\u2010fidelity training simulator for transoral robotic posterior hemiglossectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We constructed a transoral robotic surgery (TORS) simulator using porcine tongue in a modified airway mannequin. Twenty\u2010nine surgeons performed transoral robotic posterior hemiglossectomy on the simulator. The 20 resident subjects completed six trials each, and the five fellows and four attending surgeons completed two trials each. In addition to instrument vibrations, surgical video was recorded for each trial and was blindly rated using the Global Evaluative Assessment of Robotic Skill (GEARS), a validated instrument for assessing robotic surgical skill.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Attending surgeons were faster (<jats:italic>P<\/jats:italic> = .004) and demonstrated greater technical skill than fellows or residents (<jats:italic>P<\/jats:italic> &lt; .001). Resident completion time generally decreased over the study, becoming significantly faster by the fifth trial (<jats:italic>P<\/jats:italic> = .02). A similar trend was seen in resident GEARS scores, which generally increased and were significantly improved by the fourth trial (<jats:italic>P<\/jats:italic> = .008). Instrument vibrations were not significantly different between subject groups. Finally, subjects highly rated the realism and training value of the TORS simulator (mean 4.4 and 4.7 out of 5, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The reported findings support using the described simulator as a training tool for TORS. Residents significantly improved in speed and technical skill over the course of six trials but did not achieve the performance levels of attending surgeons. These results demonstrate that high\u2010fidelity simulation is a valuable tool for training novice surgeons in transoral robotic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA. <jats:italic>Laryngoscope<\/jats:italic>, 127:2790\u20132795, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26733","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T12:56:38Z","timestamp":1498654598000},"page":"2790-2795","source":"Crossref","is-referenced-by-count":15,"title":["Evaluation of high\u2010fidelity simulation as a training tool in transoral robotic surgery"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6879-6453","authenticated-orcid":false,"given":"Andr\u00e9s M.","family":"Bur","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Kansas City Kansas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest D.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason G.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory S.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Bert W.","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H.","family":"Rassekh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine J.","family":"Kuchenbecker","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering and Applied Mechanics University of Pennsylvania Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.05.035"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24572"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24571"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24570"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24475"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000369624"},{"key":"e_1_2_6_8_1","volume-title":"Transoral Robotic Surgery (TORS)","author":"Weinstein 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