Surgical training consoles are nowadays standard equipment for RAS workstations. These consoles allow for effective educational and proficiency development of surgeons in RAS. These systems are designed to simulate the real-world environment of robotic surgery, thus providing trainees with hands-on experience that closely mimics actual surgical procedures.

The surgical training consoles are nearly identical to the surgical console used in the operating room, including the control joysticks, foot pedals, and stereoscopic 3D display. This setup allows trainees to familiarize themselves with the equipment they will use during real surgeries.

Training on actual surgical consoles provides a highly realistic experience that closely mimics real-world surgery scenarios. This hands-on practice helps younger surgeons to develop the muscle memory and hand–eye coordination required for robotic surgery.

Virtual reality (VR) technology allows users to interact with simulated environments through computer-generated visuals [20]. VR typically utilizes goggles or headsets to provide visual output and enables user navigation and manipulation within these environments using specialized devices. This technology has opened doors for novel training methods in robot-assisted surgery.

VR offers a relatively user-friendly training platform. Trainees can benefit from risk-free practice in simulated surgical scenarios. This allows them to develop essential skill sets, including robotic arm manipulation. VR is also valuable for experienced surgeons who can rehearse complex procedures, particularly those involving challenging patient anatomy [21, 22]. Prolonged practice in VR environments can enhance muscle memory, leading to improved hand–eye coordination during actual surgeries.

Furthermore, high-quality VR simulations provide a realistic surgical experience by replicating the operating theater environment, including surgical instruments and visual output. This immersive experience is particularly beneficial for honing EndoWrist manipulation skills, such as grasping and clutching instruments, adapting to 3D visualization, and manipulating instruments and camera tools. Haptic feedback functionality in some VR simulators further enhances realism by allowing trainees to experience tissue resistance. Several commercially available VR simulation workstations cater to robot-assisted surgical training, including the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, California), the dV-Trainer, the Flex-VR Trainer, and the RobotiX Mentor (Surgical Science, Gothenburg, Sweden).

The da Vinci SimNow, designed for the da Vinci Surgical System, serves as an example of such VR training platforms. This software offers multiple learning pathways designed for surgeons, physicians, operating room staff, residents, and fellows. Users can select various learning techniques, such as case observation (remotely observing surgical procedures) or virtual simulation sessions practicing diverse surgical scenarios. Additionally, in-center training under the supervision of experienced surgeons is available [23].

Despite its advantages, VR and console simulation for robot-assisted surgery training is not without limitations [24,25,26,27]. The cost of acquiring simulator setups can reach thousands of dollars, and adapting older hospital or university facilities to accommodate VR systems can incur additional expenses. While newer facilities can integrate VR training rooms during initial construction, retrofitting existing buildings can be costly. Furthermore, licensing fees for advanced training software are often not included in the initial purchase price of VR simulators.

Another limitation is the potential for incomplete real-world scenario replication in VR simulations. Technical failures and emergency complications, such as vessel ruptures due to excessive force application, may not be adequately represented. While some VR simulators incorporate haptic feedback, the transition to robotic surgery systems lacking this feature can create adaptation difficulties for trainees. Additionally, VR training primarily focuses on technical aspects of surgery, potentially neglecting crucial elements like communication, decision-making, and teamwork, which are fundamental to successful surgical outcomes [28].

Prolonged VR training sessions can also lead to stress, psychological burnout, or exhaustion. Training regimens should be individually tailored to a trainee’s physical and mental capacity to prevent negative mental health consequences, while ensuring that sufficient surgical experience will be gained from each session. Implementing short breaks between training sessions can further enhance overall learning outcomes [29]. Trainees should be informed and prepared for these potential psychological factors before commencing VR training.

The long-term effectiveness of VR training in robot-assisted surgery requires further investigation. To maximize learning outcomes, educational institutions need to implement long-term studies evaluating the effectiveness of VR training. These studies should explore the adaptation and modification of clinical scenarios, VR learning methods, and trainee–instructor interactions to optimize skill development for real-world surgical practice [30].

Overreliance on VR simulators during training is a potential risk that academic faculties and VR simulator developers should consider when designing validation processes for VR surgical training. Effective validation can motivate trainees to achieve better outcomes and solidify the position of VR training within surgical curricula. Ultimately, improved VR training will translate to higher-quality surgical procedures and better patient outcomes.

Future VR training systems should explore the integration of artificial intelligence (AI). AI algorithms have the potential to enhance training by providing personalized feedback based on trainee performance. For example, AI can track user movements, analyze training inaccuracies, and provide step-by-step guidance or answer questions during simulations. Additionally, AI can contribute to the development of more realistic training scenarios by adapting them to incorporate unforeseen events that may occur during actual surgery [31, 32].

Finally, to ensure widespread accessibility of VR training platforms, government and local policymakers should explore funding initiatives to equip healthcare centers with these valuable training tools [33].