Robotic ATLAS: Adapting Advanced Laparoscopic Suturing Training to a Robotic Platform with Proficiency Benchmark Scores

Background : The Advanced Training in Laparoscopic Suturing (ATLAS) curriculum teaches complex suturing skills. With the rise of robotic-assisted surgery, it was adapted for robotic platforms (R-ATLAS). Objectives : To adapt ATLAS for robotic suturing and establish expert-derived proficiency benchmarks. Methods : Six ATLAS tasks were modified for robotic instrumentation, and a new non-dominant hand suturing task (3ND) was added. Four expert robotic surgeons each performed five repetitions per task using a robotic trainer. Performances were video-recorded, scored by an independent reviewer, and outliers (±2 SD) excluded. Trimmed means and adjusted SDs defined Basic, Advanced, and Expert benchmarks. NASA Task Load Index (NASA-TLX) assessed workload. Results : Six of 120 attempts were excluded. Benchmarks were established for all seven tasks. NASA-TLX scores ranged from 14.5–30, with Task 3 and 3ND most demanding. Conclusions : R-ATLAS offers a structured, proficiency-based robotic suturing curriculum for integration into surgical training.