Surgical Training by
Simulation on Physical Models
Published Aug 24, 2025
Updated May 9, 2026
As in every surgical training, simulation is an essential component of robotic surgery training. Simulation-based education allows surgeons to acquire technical skills in a safe, reproducible, and structured environment before performing procedures in the operating room. Among the different simulation modalities available today, training on physical models remains one of the most valuable approaches for developing practical surgical skills. Physical simulation bridges a gap between virtual simulation and live surgery by recreating anatomical structures, tissue interaction, instrument handling, and procedural workflows in a realistic hands-on setting, although it is not (for the m0ment) a substitute for cadaveric dissection.
Robotic surgery requires the acquisition of specific psychomotor abilities that differ from conventional open or endoscopic surgery. Surgeons must adapt to indirect tissue manipulation, wristed robotic instrumentation, loss of tactile feedback (hopefully not for long), camera control and spatial orientation, bimanual coordination, energy device handling, team communication and docking workflows.
While console virtual simulators are excellent for learning basic robotic skills, physical models provide an additional level of realism that is critical for procedural training.
Training on physical models allows surgeons to develop dissection strategies, improve depth perception and instrument control, rehearse exposure and retraction techniques, train assistants and operating room teams. adn repeat procedures in a standardized environment.
Physical simulation also facilitates deliberate practice, one of the key principles of modern surgical education.
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 have already started 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.
Types of Physical Models
Several types of physical simulation models are currently used in robotic surgery training.
Synthetic Models. Synthetic models are among the most widely used tools for robotic simulation training. These models are manufactured using silicone, polymers, hydrogels, or hybrid composite materials that reproduce anatomical structures and tissue resistance. Some advanced models also incorporate replaceable cartridges and modular anatomy, allowing repeated procedural practice.
3D-Printed Models. Three-dimensional printing has significantly expanded the possibilities of physical simulation. Patient-specific anatomical models can now be generated from CT or MRI imaging data, enabling realistic rehearsal of complex robotic procedures. 3D-printed simulators are especially useful for anatomical orientation, surgical planning, customized procedural rehearsal, resident education, and complex case discussion. Different printing materials can simulate variations in tissue density and consistency, improving realism.
Hybrid Models. Hybrid simulators combine synthetic materials with biological tissue or embedded technological components. These systems attempt to reproduce yissue handling, bleeding simulation, energy device interaction, suturing realism, and dynamic anatomical movement.
Advantages
- Standardization
- Reproducibility
- Availability
- Lower biohazard risk
- Easier storage and transport
- Possibility of repeated training sessions
Limitations
- Cost of high-fidelity models
- Limited tissue realism in some systems
- Lack of true bleeding or physiological response
- Need for dedicated robotic platforms
- Variable anatomical accuracy
No simulation model can fully replicate live surgery. For this reason, physical simulation should be integrated into a broader multimodal curriculum that may include virtual simulation, cadaveric dissection, didactic teaching, and supervised clinical experience.
However, physical simulation continues to evolve rapidly. Future developments may include AI-enhanced feedback systems, augmented reality integration, smart sensors and motion analysis, patient-specific procedural rehearsal, improved biomaterials, modular procedural platforms or remote collaborative simulation.
As robotic surgery becomes more widespread, physical simulation will likely play an increasingly role in credentialing, certification, and continuous professional development. The continued development of high-fidelity physical models will further enhance robotic surgical education and contribute to safer and more efficient patient care.
Some companies providing physical models.
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