Showcase

Robotics

CAMES Robotics is a centre of excellence for robotic surgical training and educational research - offering best practice training programmes for doctors and surgical nurses in robotics across multiple systems.

What we do - and offer

Development and advice

We help with tailored robotic surgery training for clinicians and industry. Our expertise also includes developing, building and advising on phantoms that can be used for robotic surgery.
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Robotic surgery training

With our basic course in robot-assisted laparoscopic surgery, you'll get cross-training in surgical specialties. We also offer bespoke training for doctors on our robotic surgery systems.
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Research

At the heart of CAMES Robotics is a research-based approach to education, training and development. This is reflected in a number of research projects that we are involved in.
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Why CAMES is betting on robotics

In the future, more patients will be operated on using a robot. Robotic surgery has already been extended to several surgical specialties with great benefits for both surgeons and patients. For example, almost all operations for prostate cancer are performed as robot-assisted surgery in Denmark. It is therefore crucial that future surgeons receive the best possible training - precisely to ensure the best treatment for patients.

Through research, development and international collaboration, CAMES Robotics has entered the national and international map at record speed - and clinical students are flocking to train in robotic surgical skills.

CAMES designs industry-independent robotic surgical training targeted at clinicians in Denmark - and is the national focal point for training, development and introduction of new versions of robots and related technology. Robotic technology is also an opportunity to perform minimally invasive surgery with superior ergonomic benefits to the surgeons' working environment.

Contact

Please contact us if you would like to know more about our services, training offers - and cooperation opportunities.

Jan Viberg, Development and Project Manager, CAMES Robotics - 60247951 / jan.viberg.jepsen@regionh.dk Read bio
Louise Møller, Team Coordinator, CAMES Robotics - 40479868 / louise.moeller.04@regionh.dk. Read bio.
Ditte Camillus, Course Director, CAMES Robotics - 5177 7209 / ditte.camillus@regionh.dk.
Flemming Bjerrum, MD, Ph.d - fbjerrum@gmail.com. See bio

Peter Hertz, PhD student - hertz.peter@gmail.com. Read bio
Jannie Lysgaard Poulsen, PhD student and doctor - Mail: jannie.lysgaard.poulsen@regionh.dk. Read bio
Rikke Groth Olsen, MD, PhD student, rikke.groth.olsen@regionh.dk. Read bio

 

CAMES Robotics is part of CAMES Rigshospitalet. You can find us here:

Ryesgade 53B
2100 Copenhagen
Denmark

facilities

Virtual tour: check out our robotic surgery systems

At CAMES Robotics we offer training and education on 3 different robotic surgical systems.

  • Intuitive DaVinci Xi system including VR simulator.
  • Medtronic Hugo RAS system including VR simulator.
  • Avatera robotic surgical system incl. VR simulator.

Use the arrows - and take a look at the different systems yourself via our 3D viewer. Please contact us if you have any questions about our systems - or would like to book a tour.

Development and advice

How we find solutions together with you

CAMES Robotics offers - in addition to robotic training - a dedicated team that researches, develops and advises on robotic-assisted surgery in general. We can help with supervision, sparring and advice. In addition, we can offer training or testing of equipment or new technologies in all areas where robot-assisted surgery is used.

Do you need help with existing or new projects? Or perhaps a development cooperation? Please contact us for a collaboration, tour or appointment. This also applies, of course, if your educational institution or organisation needs more knowledge about robotic surgery - or you as a student need input for larger tasks or similar.

Robotic surgery training at CAMES

Tailor-made courses

Looking for courses, training and education in Robotic Assisted Surgery (RAS)?

If the answer is yes, then CAMES Robotics can definitely help. We offer basic, advanced and team training courses targeted at relevant staff groups in the hospital sector. Primarily surgical nurses, specialists and doctors in training to become specialists. However, other relevant staff such as anaesthetists and other surgical staff may also be involved.

Basic and advanced procedure specific courses consist of modules with e-learning, simulation training on models and dead tissues, simulation training on simulators such as "virtual reality" and simulation training on living tissues (pigs). These courses take place at CAMES and other facilities outside hospitals.

As mentioned, CAMES Robotics also offers training of the robotic surgical team in-house. The team training is an optional module to the Basic Robotic Surgery Course, based on the clinical practice of each department. This focuses on non-technical skills and patient safety. It is not a prerequisite that students have completed the basic course, but the team training is targeted at teams with some experience in robotic surgery. The team training is provided by our associate trainers who are trained in facilitating team training in full-scale simulation.

Procedure-specific courses

CAMES Robotics offers procedure-specific courses in robotic surgery.

Currently 3 courses are offered in urology - renal surgery (RAPN and AH) and prostate surgery (RARP). Major work is underway to develop a larger portfolio in both urology (cystectomy), surgery (HPB surgery, colon and rectal surgery, hernia surgery etc), gynaecology and thoracic surgery.

The main focus is on technical training in the console, but there is also a strong emphasis on communication and team training. There will be training on several different models, including 3D silicone models, but also live pigs. This will be complemented by VR simulation training, theory and literature review and "tips and tricks".

Facilities and teaching staff are anchored in CAMES Robotics and close collaborators, but collaboration with other Danish simulation centres has been initiated.

The courses are designed as high intensity courses with few participants and "1 to 1" supervision. Some experience with robotic surgery is required and preparation and follow-up time must be allocated. Course participants are systematically assessed and advised based on progression and in some cases must pass simulation tests.

Are you looking for Robotic Surgery courses?

We match your needs for courses, training and education in Robot Assisted Surgery (RAS)

Please contact us if you have any questions, want to know more - or want to book either a tailor-made or procedure-specific RAS course.

Jan Viberg, Development and Project Manager, CAMES Robotics - 60247951 / jan.viberg.jepsen@regionh.dk. Read bio.
Louise Møller, Course Manager, CAMES Robotics - 40479868 / louise.moeller.04@regionh.dk. Read bio.

Basic course

Education and training in robotic surgery

We offer
CAMES Robotics offers Robotic Surgical Training - Basic Course. This is a training course aimed at providing students with an introduction to robotic-assisted laparoscopic surgery, across the surgical specialties. The training is offered approximately 1-2 times per month, corresponding to approximately 8 classes per semester. Each team consists of two physicians and two surgical nurses.
Target groups
For surgical nurses, it is part of their training to provide non-sterile and sterile assistance for robotic surgery. For physicians, the training is a prerequisite for assisting in robotic surgery and, in the long term, for starting lateral training as a console surgeon.
Modules

Get the overview here

Teachers
CAMES Robotics has a permanent team of external lecturers, all with solid experience in robot-assisted surgery.
Location
Education and training in robotic surgery takes place at these sites:

CAMES Herlev
Herlev Hospital
Mayor Ib Juuls Vej 1,
2730 Herlev
Elevator, Floor 4 of Cames, basement, K1
Find your way/parking, via this Link

CAMES Rigshospitalet
Rigshospitalet, section 98A41
Ryesgade 53, 4th floor
2100 KBH Ø

Panum, KU.
Blegdamsvej 3B
2200 KBH.N.
Department of Experimental Medicine
Operating Room 16.3 (Building 16, 3rd floor)
Find your way/parking, via this Link

Team training in own department
CAMES Robotics offers training of the robotic surgical team - including the anaesthesia team - in its own department. The team training is an optional module to the Robotic Surgical Education Basic Course, based on the clinical practice of each department, with a focus on non-technical skills and patient safety.

It is not a prerequisite that students have completed the Basic Course but the team training is targeted at teams with some experience in robotic surgery. The team training is provided by CAMES Robotics associate trainers who are trained in facilitating team training in full-scale simulation.

video

Visit the robotic surgery "operating theatre"

Together with CAMES Engineering, we develop various 3D models in synthetic material, which are typically used in procedure-specific robotic surgery courses. Here, trainees are trained repetitively in, for example, anastomoses (sutures) where living tissue is not necessary. In the video you can see elements of a training course on two of our robotic surgery systems.

(Cutting and stitching on silicone model of stricture at transition between renal pelvis and ureter).

Our partners

We were set up to develop new and better methods in robot-assisted simulation training. Want to be part of the journey? Please contact us.

Robotic surgery research at CAMES

cases

Current projects

3D printed models for robot-assisted colorectal cancer

Colorectal cancer is a common disease, and in Denmark about 3,400 people are diagnosed with colorectal cancer each year. Surgical removal of the cancer is one of the cornerstones of treatment, and there is an increase in the number of robotic-assisted operations.

To meet a greater need for surgeon training and to develop training opportunities, we have developed a 3D printed phantom, based on patient scans, to train robotic surgical removal of the right part of the colon.

Objective
The PhD project investigates whether it is possible to perform reliable competence assessments of surgeons when performing an advanced robotic surgical procedure for colon cancer. Furthermore, it is investigated whether the competence assessment performed in the simulated environment is consistent with the surgeon's performance during real operations,

The researchers behind the project are also looking at the following

  • What basic surgical skills a robotic surgeon should have
  • What assessment tools are available to assess this, whether the assessment tools are reliable
  • Whether the assessment tools can be used to identify a learning need in the individual surgeon

The PhD project is carried out as a collaboration between Kolding Hospital in the Southern Region and CAMES. The PhD student carrying out the project is: Peter Hertz, Reserve Physician, Organ Surgical Department, Lillebølt Hospital, Kolding Hospital. PhD student at the Department of Regional Health, University of Southern Denmark.

Contact:

Peter Hertz, PhD student - hertz.peter@gmail.com. Read bio

 

Team training in robotic surgery

The PhD project is about investigating the non-technical skills of the robotic surgical team.
The robotic surgical team differs from other health professional teams in that one of the team members - the surgeon - is physically separated from the rest of the team and the patient bed. This affects teamwork, including coordination. Among other things, the team does not have eye contact with the surgeon during the operation, who also cannot see the operating theatre, but only the video screen with the operating field.

We examine and compare how the experienced and inexperienced robotic surgical teams coordinate their work to optimize teamwork and patient safety. Team coordination has an impact on workflow and on the risk of errors during surgery. Training teamwork can reduce errors and increase patient safety

The project contributes to the development of the Capital Region's robotic surgery training, where teamwork is trained to increase patient safety in both routine and emergency situations.

The PhD students carrying out the project are: Doctor Jannie Lysgaard Poulsen, who is a PhD student at the University of Copenhagen and at the Copenhagen Academy for Medical Education and Simulation at Herlev Hospital.

Contact: 

Jannie Lysgaard Poulsen, PhD student and doctor - Mail: jannie.lysgaard.poulsen@regionh.dk. Read bio

Machine learning in robotic assisted prostate removal

Prostate cancer is one of the most common cancers worldwide, accounting for about 15% of cancer diagnoses in men.

For localised prostate cancer, many people have a robot-assisted radical prostatectomy. It aims to achieve cancer control while maintaining continence and potency. These patient outcomes are highly dependent on the surgeon's level of experience both in general, but also on the day itself.

The experience level of surgeons is generally described in terms of the number of operations performed to date, but this does not tell us anything about how the surgeon performs each operation. It may therefore be difficult at this stage to predict patient outcomes for individual patients.

Robotic surgery now makes it easier to follow the surgeon's movements and actions during the operation. These are automatically recorded by the robot, and new research suggests that this data can be used to predict patient outcomes.

The PhD project investigates. Whether we can predict both short-term and long-term patient outcomes in men who have undergone robot-assisted radical proctomy using the surgeon's movement patterns pg actions.
The project is carried out as a collaboration between the Urological Research Unit / Copenhagen Prostate Cancer Center and the Copenhagen Academy for Medical Education and Simulation.

Rikke Groth Olsen, PhD student at the University of Copenhagen and Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Contact:

Rikke Groth Olsen, MD, PhD student, rikke.groth.olsen@regionh.dk. Read bio

Training of robot-assisted cardiac surgery

Robotic-assisted heart surgery performed through small holes in the chest using a robot is a more gentle surgical method than traditional "open" heart surgery. Despite its advantages, the method is slowly spreading around the world.

One of the reasons is the lack of training and competence assessment of cardiac surgeons in robotic surgery.
In the PhD project, the researchers want to validate a concrete competence assessment method for robot-assisted cardiac surgery. An international panel of robotic surgery experts has been assembled to help establish expert standards for competency assessment of new robotic surgeons. Next, the amount of training required to achieve expert level for new robotic surgeons in a simulated environment will be investigated.

Aims and objectives: 

The results of the study will help establish competency-based training for cardiac surgeons, so that we can also implement this new and more gentle surgical method in Denmark. In addition, the study will generate new knowledge on how to design models that can be used for training without involving real patients.

Cooperation

The project is the result of a collaboration between European experts in robotic-assisted cardiac surgery (Belgium, the Netherlands, Spain, Czech Republic), cardiac surgery specialists (Denmark) and medical education researchers (Copenhagen Academy for Medical Education and Simulation and Western University, London Health Sciences Center, Canada). The project is carried out at Aalborg University Hospital.

The PhD students carrying out the project are: Gennady V. Atroshchenko, Specialist in Thoracic Surgery, Department of Cardiothoracic Surgery, Aalborg University Hospital.
PhD student at the Department of Clinical Sciences and Aalborg University.
Responsible for research and course management in robot-assisted cardiac surgery, ROCnord, Aalborg.

Contact

Gennady V. Atroshchenko, Specialist in Thoracic Surgery, MD, PhD student. Read bio

Automated competence assessment of robotic surgeons using AI

Robotic surgery is increasingly used - both in Denmark and abroad. With the introduction of new technology also comes a need for training and continuous assessment to ensure safety in treatment.

So far, competence assessment has been based on expert surgeons' assessment of the skills of future surgeons. Artificial Intelligence (AI), on the other hand, represents a new way of assessing competence and may ensure that future surgeons acquire the necessary skills before operating independently.

In a national collaboration between Aalborg University Hospital and CAMES, a multidisciplinary team of doctors and engineers will use artificial intelligence to develop competence assessment tools for robotic surgeons. This could reduce errors and increase the quality of robot-assisted kidney surgery.

PhD student conducting the project is Nasseh Hashemi, MD
PhD student at the Department of Clinical Sciences, Aalborg University and Nordsim, Center for Skills Training and Simulation and ROCnord, Aalborg 

Contact: 

Nasseh Hashemi, MD, PhD student, Mail: n.hashemi@rn.dk Read bio.


Contact:

Flemming Bjerrum, Research Manager, CAMES Robotics: MD, Ph.d - fbjerrum@gmail.com. See bio

 Research areas

Robotic surgery presents a number of challenges for the surgical team that are not seen in other types of surgery. For example, the surgeon is more isolated from the rest of the team and sits further away. This can make communication within the team difficult. Robotic surgery is also characterised by more sophisticated equipment, which places different demands on the surgical nurses.

Optimal and effective training of robotic surgeons and robotic surgical teams requires a systematic examination of the competencies that should be included in a training programme. CAMES does this by using, for example, Delphi surveys to identify in a systematic and structured way the domains and elements that should be included in the training and to ensure that there is consensus on this. In addition, it is also necessary to examine for whom these competences are relevant - as well as which training methods are the optimal ones.

The first step - when it comes to acquiring the technical surgical skills required by robotic surgeons - is simulation training on, for example, physical models or virtual reality simulators.

To optimise training as much as possible, it is important to have simulators with built-in measuring instruments that can be used to give feedback during training and used for competence assessment. Precisely to assess when surgeons are ready to start operating on patients under supervision.

CAMES has years of experience in developing and testing simulators for many surgical procedures - including robotic surgery. For CAMES, the identification of relevant measurement parameters is an important focus area. So is ensuring their validity and reliability, and defining training objectives and pass limits. In particular, we are specialists in making it practical, which is often a challenge.

When designing a robotic surgery training programme, it is crucial to create an effective training programme that ensures surgeons achieve the desired competencies. This is best done by using mastery learning to a predefined level.

But it is equally important that training is as effective as possible to avoid spending more time than necessary. For example, the best technical skills are achieved if training is spread out over time. Or if you explore the role of technological aids in training - such as tactile response or 3D displays.

CAMES has experience in the design of evidence-based training programmes and conducts research in the optimisation of simulation training.

The introduction of robotic surgery - operating on a console that controls an operating robot - also introduced the digitisation of surgery. This allows data to be collected on the surgeon's performance of an operation - such as instrument movements, actions, use of energy instruments and much more.

New research suggests that this data, combined with machine learning models, can be used to assess the quality of an operation and predict consequences after surgery. CAMES is researching the use of metrics in robotic surgery and how this can be used to improve patient care - including in the education and quality assurance of robotic surgery.

We use research both in relation to data from surgical robots, but also advanced video analysis of real and simulated operations.

Robotic surgery is mainly used for advanced operations - such as colon cancer, prostate removal and major hernia operations. This places high demands on the training models used to train robotic surgeons. Virtual reality simulators are an essential part of robotic surgery training, but difficult to develop for advanced procedures with complex anatomy.

CAMES is developing 3D-printed models in tissue-like materials from reconstructions of patient scans, which are used to train advanced surgeons - and also to assess their skills. Developing these models requires close collaboration between engineers, surgeons and training specialists.

In the long term, this could be used for patient-specific training based on the patient's CT or MRI scans.