Surgical Training by
Virtual Simulation
Chronology
Updated August 2025
(Created August 2025)
Aug 2025. SimNow2 (Intuitive).
The training process for surgery has evolved significantly over time, although some fundamentals have remained constant. Models have always played a central role in surgical education—for example, every surgeon learns how to tie knots using dedicated training models. With technological advances, these models became increasingly sophisticated, with endoscopic surgery marking a major turning point in simulation-based training.
A similar evolution has taken place in robotic surgery, with one remarkable difference: virtual training was introduced almost from the very beginning. Robotic surgical training follows the same fundamental steps as other surgical disciplines, but simulators added a new dimension by allowing immersive, software-based practice.
Robotic simulators enable surgeons to develop hand–eye coordination, instrument handling, and procedural skills in a risk-free environment. They provide structured training modules with objective performance metrics, and are increasingly capable of replicating real surgical scenarios. In this way, simulation not only supports robotic training but also opens broader possibilities for surgical education as a whole.
Evolution of the da Vinci Simulator
The first virtual training platform for the da Vinci system was the Skills Simulator, later replaced by SimNow. Both systems functioned as hardware “backpacks” attached to the surgeon’s console, allowing integration of simulation with the robotic platform.
With SimNow, Intuitive introduced cloud-based support. Access was managed via an online platform, where each trainee registered, selected a role (e.g. surgeon), and received a personal login code. This ensured individualized training pathways and performance tracking.
With the launch of the da Vinci 5 system, simulation has been fully integrated into the software—eliminating the need for separate hardware. Intuitive has also announced the release of SimNow2, which is expected to further expand cloud integration and virtual learning capabilities.
Training Pathways and Applications
In official training programs, there is usually a minimum curriculum that must be completed in order to obtain manufacturer certification (e.g., Intuitive’s licensing process). However, the potential applications of virtual training extend far beyond robotic credentialing. Since training modules are software-based, virtually any scenario can be simulated—for example, learning basic suturing techniques and knot tying with guided feedback, or complete surgical procedures.
Alternative Platforms
Other companies have also recognized the importance of simulation. The Versius Trainer (CMR), for instance, is a state-of-the-art simulation platform that provides surgeons and surgical teams with a structured and immersive training environment tailored to the Versius Surgical Robotic System. Its aim is to reduce learning curves, enhance safety, and ensure effective adoption of robotic-assisted surgery.
There are other virtual training platforms in the market, like RoboS.
Future Directions
The future of robotic surgery simulation will likely focus on expanding the range of procedure-specific training modules, including, hopefully, Transoral Robotic Surgery (TORS). Technological advances—such as enhanced 3D visualization, realistic haptic feedback, and artificial intelligence—are expected to improve realism, personalization, and adaptive learning. These developments will not only refine robotic surgery training but also shape the broader landscape of surgical education.
Related posts
Intuitive introduces SimNow 2, the next generation of simulation technology August 24, 2025
Exploring simulation training at the European University of Madrid: Virtamed Robotic Simulator (RoboS) May 13, 2025
Simulation training for robotic surgery Dec 25, 2021
Simulation training for robotic surgery Dec 20, 2020
Robotic Surgery Systems
da Vinci (Intuitive)
Versius (CMR)
Hugo (Medtronic)
Links
– Intuitive Surgery
– Intuitive learning (restricted access)
– Abex (da Vinci in Spain)
J Granell
Robotic Surgeon
I started to perform robotic surgery in year 2013 with the da Vinci S (2nd generation). I directed my first hands-on training course in 2015 with a da Vinci Standard (1st generation). I act as clinical proctor since 2017. I have tested da Vinci 5 and will start in clinic with the SP soon. I do have experience in experimental or clinical setup with each one of the models of the da Vinci Surgical System. I know Hugo, and do have experimental experience with Versius. Also knew Medrobotics Flex.
Before starting my practice in robotic surgery I did have a solid foundation as an oncologic surgeon, both in resective and reconstructive procedures, and also in minimally invasive surgical approaches and endoscopic surgery, with are clues for success in this area of expertise.