The daVinci Surgical System offers surgeons improved capabilities for performing complex minimally invasive
procedures; however, there is no standardized assessment of robotic surgeons and a need exists to ensure that a
minimal standard of care is provided to all patients. The Department of Defense and governing surgical societies
convened consensus conferences to develop a national initiative, resulting in a curriculum called the
Fundamentals of Robotic Surgery (FRS). FRS is comprised of an online curriculum and a psychomotor skills
dome.
This paper describes the production process used to create a psychomotor skills assessment device - the FRS
Dome. The device was designed to measure the essential skills that are required of any robotic surgeon and to
provide a basis upon which to grant or deny privileging with the robot. It was constructed to test seven tasks of
manual dexterity: Docking, Ring Tower Transfer, Knot Tying, Suturing, 4th Arm Cutting, Puzzle Piece
Dissection, and Energy Dissection.
The initial design of the device was created by a committee of experienced minimally invasive surgeons, with a
background in testing protocols and materials. The design was rendered in computer animation, which kickstarted
a prototyping effort with physical materials. These included platinum cure silicone approximating human
tissue and a 3D polyjet printer for the structural framework. Usability testing was conducted and iterative
modifications were made to improve ergonomics, standardization, and cost requirements. Final CAD diagrams
and specifications were created and distributed to medical and simulation companies for both physical and
digital manufacturing. This development process demonstrates the evolution of a simulation and a physical
testing device based on international expert consensus. The specifications are open source, allowing competitive
production and future iterations. The goal of this paper is to discuss how this device evolved from an idea to a
manufactured product and a digital simulation.