Center for Robotic Simulation and Education

About the Center

Led by Andrew J. Hung, MD, the Center for Robotic Simulation and Education (CRSE) is home to a pioneering team of surgeons and data scientists. The center’s primary mission is to advance the way robotic surgeons are trained. With partnerships with industry organizations and other leading academic institutions around the world, we hope to set the standards on how robotic surgery is taught.

The center’s objectives parallel one of the main missions of the USC Institute of Urology: to innovate in the field of minimally invasive urology. Every day our surgeons strive to advance how we treat patients with benign and malignant urologic diseases. Many important techniques in how we treat prostate cancer, bladder cancer, and kidney cancer were created here at the USC Institute of Urology.

CRSE runs a parallel mission to ensure that our pioneering feats do not belong to a single surgeon or single hospital. We hope to relay our techniques to a worldwide audience of robotic surgeons.

Since 2011, the Center has:

• Developed the first procedure-specific simulation for robotic surgery (Maestro AR Partial Nephrectomy, Mimic Technologies)
• Demonstrated for the first time that virtual reality (VR) simulation training can improve live robotic surgery performance (Journal of Urology, 2012)
• Captured and validated for the first time automated surgeon performance metrics for live robotic surgery (Journal of Urology, 2018)
• Linked automated surgeon performance metrics utilizing machine learning algorithms to patient clinical outcomes (JAMA Surgery, 2018 and British Journal of Urology International, 2019)
• Produced over 27 peer-reviewed articles on robotic simulation and training in leading journals

CRSE Team

Andrew J. Hung, MD, Founding Director

Jian Chen, MD, Research Fellow

Inderbir Gill, MD, Chair, Aresty Department of Urology

Runzhuo Ma, MD, Research Fellow

Jessica Nguyen, Projects Manager

Research Associates

• Paul Oh– Paul Oh is a Dean’s Research Scholar at the Keck School of Medicine of USC. He is taking a year off before his 4th year of medical school to conduct full time research on the treatment of prostate and bladder cancer.
• Michael Lin-Brande– Michael Lin-Brande is a 4th year medical student participating in the Dean’s Research Scholar program. He completed his undergraduate studies at USC majoring in Business Administration and minoring in Natural Sciences. Michael’s research interests include bladder and prostate cancer.
• Micha Titus– Micha Titus is a medical student at the Keck School of Medicine and doing research at the CRSE. He came to USC after graduating from Emory University. His research focus is evaluating the impact of trainee involvement on outcomes in robotic surgery.
• Austin Fullencamp– Austin Fullenkamp is a medical student at Keck School of Medicine in the Health, Technology, and Engineering program. His research interests include surgical training education, surgical robotics, and technology development.
• Tiffany Chu – Tiffany is a medical student at Keck School of Medicine. She graduated from USC with a degree in economics. Her research interests include the use of robotic surgery in treating genitourinary disorders.
• Ryan Lee – Ryan is a medical student at the Keck School of Medicine. He attended USC for his undergraduate studies where he majored in Human Biology. His research interests include outcome studies and development of teaching models for robotic surgery.
• Daphne Remulla – Daphne is a medical student at the Keck School of Medicine. Her research interests are in medical education with a focus on surgical pedagogy and learning analytics in urology.
• Vivek Singh – Vivek is a medical student at the Keck School of Medicine of USC. He completed his undergraduate studies at UCLA, majoring in Physiological Science. His research interests include surgical robotic technology and surgical training education.
• Jessica Nguyen – Jessica is a student completing the post-baccalaureate pre-medical program at USC. She completed her undergraduate studies in biomedical engineering from UCI. Her interests include surgery and biomedical technologies.
• Andrew Chen, MD – Andrew Chen is a resident physician in the department of urology at USC. His research interests include surgical training, robotic surgery, as well as applications of artificial intelligence in medicine.
• Shubham Bhatia, MD – After graduating from Delhi University, India, Dr. Shubham Bhatia joined CRSE under Dr. Hung’s leadership following his passion to be at the intersection of robotic surgery, technology, and surgical education. He aspires to pursue a General Surgery residency. His research interests include the application of artificial intelligence and technology in predicting patient outcomes and in training of the next generation of surgeons.
• Balint Der, MD – Dr. Der is a postdoctoral research fellow at Keck School of Medicine, USC. He completed his MD degree at Semmelweis University, Hungary. His research interests include everything related to the (patho)phyiology, therapeutic and treatment options of the organs of the urinary tract, more specifically robotic surgery and kidney development/regeneration
• Samuel Mingo – Samuel is a medical student at the Keck School of Medicine of USC. He completed his undergraduate studies at the University of Notre Dame, majoring in Chemical Engineering. His research interests include surgical robotic technology and surgical training education.
• Andrew Cowan – Andrew Cowan is a student at the Keck School of Medicine in the Health, Technology and Engineering program. He received his BFA in Dance from NYU and enjoyed a successful decade as a professional dancer. Through research his focus in to understand technology’s role in the future of medicine and medical education.
• Erik Vanstrum – Erik Vanstrum is a medical student at the Keck School of Medicine. He graduated from Pomona College with a degree in Neuroscience. His research interests include medical education and technology development.
• Swetha Rajkumar – Swetha is a pre-med student, who recently completed a post-baccalaureate program at USC. She previously completed her undergraduate degree at UCR where she majored in Economics. Her research interests include prostate cancer, surgical methods, and robotic technology development.
• Ryan Hakim – Ryan is a pre-medical student who completed his undergraduate studies at UC San Diego studying Biology and Psychology and is spending his gap year before matriculating to medical school as a research assistant. His research interests include robotic surgeries as well as surgeon performance and clinical outcomes.
• Aastha – She is a second-year Ph.D. student at the Computer Science department of USC-Viterbi School. Her research focuses on applied machine learning and deep learning for spatial-temporal data and computer vision.
• Siqi Liang – Siqi is a computer science master student at the Viterbi School of Engineering. She came to USC after graduating from the University of Electronic Science and Technology of China. Her research interests include machine learning, statistical learning, and their application in medicine.

Recent Center News

• May 14, 2017: 2017 American Urological Association Annual Meeting (Boston): Dr. Hung and Dr. Chen present initial findings of objective surgeon performance metrics during robotic radical prostatectomy
• June 12, 2017: Dr. Hung to present his work on telementoring for robotic surgery at the American College of Surgeons’ Training the Next Generation of Surgeons conference in Seattle (U Wash WISH)
• June 22-24, 2017: Dr. Hung to attend the “Train the Trainer” Consensus Conference (Philadephia) with leading surgical educators from around the world
• July 2017: twin manuscripts accepted in the Journal of Urology:
  1. Telementoring/Telesurgery in MIS:
     http://www.jurology.com/article/S0022-5347(17)76745-6/fulltext;
  2. Objective Performance Metrics utilizing the dVLogger during RALP:
     http://www.jurology.com/article/S0022-5347(17)77239-4/fulltext
• Dec 11 2017: CRSE team’s article on “dVLogger” data featured on the cover of the Journal of Urology January 2018 cover and covered by several media outlets.
  
• January 18, 2018: Dr. Hung, Dr. Chen and Paul Oh present work on “dvLogger” data at the annual Intuitive Surgical Clinical Grants Research Symposium
• May 2018: CRSE team presenting several moderated posters and podium talks at the AUA Annual Meeting in San Francisco.
• June 18-20, 2018: Dr. Hung will be part of the faculty at the Society of Robotic Surgery in Stockholm, Sweden
• December 2019: Dr. Hung presenting the Center’s work in AI and surgical assessment at the Bariatric Endoscopic Surgical Trends (B.E.S.T.) conference in New York City
• January 2020: Dr. Hung presenting the Center’s work in AI and surgical assessment at the University of California San Diego’s Department of Mechanical and Aerospace Engineering and Department of Surgery joint surgical robotics seminar series
• January 2020: Dr. Hung presenting about automated performance metrics at the Intuitive Surgical Annual Research Grants Symposium
• February 2020: Dr. Hung presenting at the 4th North American Robotic Urology Symposium
  Recent Awards
• March 2019 EAU Best Poster: Hung A, Chen J, Liu Z, Nguyen J, Purushotham S, Liu Y. Deep learning model to predict urinary continence after robot-assisted radical prostatectomy. Poster presented at: 2019 European Association of Urology (EAU), Barcelona, Spain.
• May 2018 AUA Best Poster: Chen J, Oh PJ, Cheng N, Shah A, Guo L, Jarc A, Hung AJ.. (May, 2018). Exploring technique of the vesicourethral anastomosis in robotic-assisted radical prostatectomy with automated and manually observed metrics. Poster presented at: 2018 AUA Annual Meeting; San Francisco, CA, USA.

Funding sources

• Intuitive Surgical Clinical Research Grant (2017-2022)
• National Institute Of Biomedical Imaging And Bioengineering of the National Institutes of Health under Award Number K23EB026493

Highlighted Publications

• Chen A, Ghodoussipour S, Titus MB, Nguyen JH, Chen J, Ma R, Hung AJ. “Comparison of clinical outcomes and automated performance metrics in robot-assisted radical prostatectomy with and without trainee involvement.” World J Urol. [Epub ahead of print], 2019. PMID: 31728671
• Nguyen JH, Chen J, Marshall SP, Ghodoussipour S, Chen A, Gill IS, Hung AJ. “Using objective robotic automated performance metrics and task-evoked pupillary response to distinguish surgeon expertise.” World J Urology. [Epub ahead of print], 2019. PMID: 31346762
• Chen J, Chu T, Ghodoussipour S, Bowman S, Patel H, King K, Hung AJ. “Effect of surgeon experience and bony pelvic dimensions on surgical performance and patient outcomes in robot-assisted radical prostatectomy.” BJU Int. 124(5):828-835, 2019. PMID: 31265207
• Chen J, Remulla D, Nguyen JH, Aastha D, Liu Y, Dasgupta P, Hung AJ. “Current status of artificial intelligence applications in urology and their potential to influence clinical practice.” BJU Int. [Epub ahead of print], 2019. PMID: 31219658
• Hung AJ, Chen J, Ghodoussipour S, Oh PJ, Liu Z, Nguyen J, Purushotham S, Gill IS, Liu Y. “A deep-learning model using automated performance metrics and clinical features to predict urinary continence recovery after robot-assisted radical prostatectomy.” BJU Int. 124(3):487-495, 2019. PMID: 30811828
• Hung AJ. “Can machine-learning algorithms replace conventional statistics?” BJU Int. 123(1):1, 2019. PMID: 30565402
• Hung AJ, Oh PJ, Chen J, Ghodoussipour S, Lane C, Jarc A, Gill IS. “Expert versus Super Experts: Differences in Automated Performance Metrics and Clinical Outcomes for Robot-Assisted Radical Prostatectomy.” BJU International. 123(5):861-868, 2019. PMID: 30358042.
• Collins JW, Dell’Oglio P, Hung AJ, Brook NR. “The Importance of Technical and Non-technical Skills in Robotic Surgery Training.” Eur Urol Focus. 583: 1-3, 2018. PMID: 30217631
• Chen J, Cheng N, Cacciamani G, Oh P, Lin-Brande M, Remulla D, Gill IS, Hung AJ. “Objective assessment of robotic surgical technical skill: A systematic review.” J Urology. 201(3):461-469, 2019. PMID: 30053510.
• Hung AJ, Chen J, Gill IS. “Automated Performance Metrics and Machine Learning Algorithms to Measure Surgeon Performance and Anticipate Clinical Outcomes in Robotic Surgery.” JAMA Surgery. 153(8): 770-771, 2018. PMID: 22926095.
• Chen J, Oh PJ, Cheng N, Shah A, Montez J, Jarc A, Guo L, Gill IS, Hung AJ. “Use of automated performance metrics to measure surgeon performance during robotic vesicourethral anastomosis and methodical development of a training tutorial.” J Urology. 200 (4): 895-902, 2018. PMID: 29792882
• Oh PJ, Chen J, Hatcher D, Djaladat H, Hung AJ. “Crowdsourced versus expert evaluations of the vesico-urethral anastomosis in the robotic radical prostatectomy: is one superior at discriminating differences in automated performance metrics?” J Robot Surg. 12(4): 705-711, 2018. PMID:29713932
• Hung AJ, Chen J, Che Z, Nilanon T, Jarc A, Titus M, Oh PJ, Gill IS, Liu Y. “Utilizing Machine Learning and Automated Performance Metrics to Evaluate Robot-Assisted Radical Prostatectomy Performance and Predict Outcomes.” J Endourol. 32(5):438-444, 2018. PMID: 29448809.
• Hung AJ, Chen J, Jarc A, Hatcher D, Djaladat H, Gill IS, “Development and Validation of Objective Performance Metrics for Robot-assisted Radical Prostatectomy: A Pilot Study,” J Urology. 199(1): 296-304, 2018. PMID: 28765067.
• Hung AJ, Chen J, Shah A, Gill IS. “Telementoring and Telesurgery for Minimally Invasive Procedures.” J Urology. 199(2): 355-369, 2018. PMID: 28655529.
• Hung AJ, Bottyan T, Clifford TG, Serang S, Nakhoda ZK, Shah SH, Yokoi H, Aron M, Gill IS. “Structured Learning for Robotic Surgery Utilizing a Proficiency Score: A Pilot Study.” World J Urology. 35(1): 27-34, 2017. PMID: 27106491.

Join Us

Send your CV to Dr. Andrew Hung (Andrew.Hung@med.usc.edu) if you are interested in a research internship or fellowship.