Training in surgery has always required repetition. Surgical skill is not only knowledge or decision making, it is also physical ability, precision, coordination, and consistency developed over time. Robotic surgery introduces a completely new set of technical skills, many of them very different from those required even in conventional endoscopic surgery. The surgeon must learn to control multiple robotic arms simultaneously, work in a three-dimensional environment, optimize camera movement, and develop a new sense of instrument interaction and tissue handling.
Virtual simulation has become one of the most powerful tools for acquiring these abilities, and the technology is evolving rapidly. In this video, the exercise shown is Active Retraction, performed using the four robotic arms of the da Vinci 5. At first glance it may resemble a video game, but it is anything but entertainment. The exercise demands absolute precision, and a perfect score (100%) is required to pass. Every movement is measured: efficiency, economy of motion, collisions, instrument control, and task completion.
What makes this particularly interesting is that the surgeon performs these exercises directly at the surgeon’s console, using the same ergonomic environment employed during real robotic procedures. The system continuously tracks progress online, providing performance metrics, personalized suggestions for improvement, scores, and recommendations for additional exercises adapted to the surgeon’s level.
Beyond isolated technical drills, complete virtual surgical procedures are also becoming available. Their realism improves constantly, moving steadily toward an experience that may eventually resemble the role flight simulators play in aviation training today. Robotic surgery is entering an era where technical skill acquisition can be structured, measured, repeated, and refined with a level of precision that was unimaginable only a few years ago.
J Granell. May 21, 2026