TABLE 1.

Important metrics identified to define surgical performance during VR RARP simulation

Module (phase)	Visual cues	Errors	Events
Bladder neck dissection (with BN preservation)	1. Define the prostate between instruments	1. Incorrect starting place for incision	1. Bladder wall undermined
	2. Bladder pedicles	2. Too cranial on the bladder	2. Button hole in the bladder
	3. Surgeon uses bladder stretch	3. Too close to the prostate	3. Damage to the UO's
	4. Area of fat lateral between bladder, prostate and NVB	4. Too much bleeding that obstructs view of surgical plane	4. Cut into the prostate
	5. Longitudinal muscle fibers of urethra	5. Inappropriate handling/trauma to the BN	5. Damage to the ureters/UO's
	6. UO's identified inside bladder neck
Preparation and dissection of the pedicles and NVBD	1. Prostate	1. Inappropriate handling or excessive traction to NVB	1. Cut into prostate
	2. Denonvillier's fascia (post)	2. Incision of Denonvillier's fascia in the incorrect plane or direction	2. Cut across NVB
	3. Prostatic pedicle	3. Not mobilizing the prostate with the assistant arm to view dissection plane	3. Clips placed across the NVB
	4. Peri‐prostatic fascias
	5. Prostatic capsule
	6. Ability to visualize NVB to perform NVBD
	7. Ability to visualize the prostate capsule and the ‘whiter’ prostate tissue if the capsule is breached
	8. Dissection of the NVB of the apex of the prostate (completing the dissection)

Abbreviations: BN, bladder neck; NVB, neurovascular bundle; NVBD, neurovascular bundle dissection; RARP, robotic‐assisted radical prostatectomy; UO, ureteral orificium; VR, virtual reality.