As surgical robots become more common, automating away some of the burden of complex direct human operation becomes ever more feasible. Model-free reinforcement learning (RL) is a promising direction toward generalizable automated surgical performance, but progress has been slowed by the lack of efficient and realistic learning environments. In this paper, we describe adding reinforcement learning support to the da Vinci Skill Simulator, a training simulation used around the world to allow surgeons to learn and rehearse technical skills. We successfully teach an RL-based agent to perform sub-tasks in the simulator environment, using either image or state data. As far as we know, this is the first time an RL-based agent is taught from visual data in a surgical robotics environment. Additionally, we tackle the sample inefficiency of RL using a simple-to-implement system which we term hybrid-batch learning (HBL), effectively adding a second, long-term replay buffer to the Q-learning process. Additionally, this allows us to bootstrap learning from images from the data collected using the easier task of learning from state. We show that HBL decreases our learning times significantly.
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