Abstract
Background
The aim of this study was to quantify the extent of dexterity enhancement in robotic surgery as compared to laparoscopic surgery.
Methods
Ten surgeons with varying laparoscopic suturing experience were asked to place three sutures on a suture pad. The sutures were placed laparoscopically, robotically with 2-D vision and robotically with 3-D vision. The da Vinci system’s Application Programming Interface (API) was used for positional data. A validated motion analysis system was used for data retrieval for the laparoscopic task. Custom software was developed for data analysis.
Results
Compared to laparoscopic suturing, when the task was undertaken robotically with 2-D vision there was a 20% reduction in the time taken but this was not significant (p = 0.07). There was a 55% reduction in the path traveled by the right hand (p = 0.01) and a 45% reduction in the path traveled by the left hand (p = 0.008). When the task was undertaken robotically with 3-D vision, there was a 40% reduction in the time taken (p = 0.01). There was a 70% reduction in the path traveled by right hand (p = 0.008) and a 55% reduction by the left hand (p = 0.08).
Conclusions
The presence of “wristed” instrumentation, tremor abolition, and motion scaling enhance dexterity by nearly 50% as compared to laparoscopic surgery. 3-D vision enhances dexterity by a further 10–15%. In addition, the presence of 3-D vision results in a 93% reduction in skills-based errors.
Similar content being viewed by others
References
R Berguer (1999) ArticleTitleSurgery and ergonomics. Arch Surg 134 1011–1016 Occurrence Handle10.1001/archsurg.134.9.1011 Occurrence Handle1:STN:280:DyaK1MvhsFGnsg%3D%3D Occurrence Handle10487599
R Beurger M Rember D Beckley (1997) ArticleTitleLaparoscopic instruments cause increased forearm fatigue: a subjective and objective comparison of open and laparoscopic techniques. Min Invasive Ther Allied 6 36–40
GF Buess MO Schurr SC Fischer (2000) ArticleTitleRobotics and allied technologies in endoscopic surgery. Arch Surg 132 229–235 Occurrence Handle10.1001/archsurg.135.2.229
A Chan S Chung A Yim J Lau E Ng A Li (1997) ArticleTitleComparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery. Surg Endosc 11 438–440 Occurrence Handle10.1007/s004649900385 Occurrence Handle1:STN:280:ByiB1MfhvVw%3D Occurrence Handle9153170
WK Cheah JE Lenzi J So F Dong CK Kum P Goh (2001) ArticleTitleEvaluation of a head-mounted display (HMD) in the performance of a simulated laparoscopic task. Surg Endosc 15 990–991 Occurrence Handle1:STN:280:DC%2BD3MrlvVCrtw%3D%3D Occurrence Handle11443461
B Davies (2000) ArticleTitleA review of robotics in surgery. Proc Inst Mech Eng 214 129–140 Occurrence Handle10.1243/0954411001535309 Occurrence Handle1:STN:280:DC%2BD3c7ot1Ghsg%3D%3D
A Dosis F Bello T Rockall Y Munz K Moorthy S Martin A Darzi (200x) ArticleTitleROVIMAS: a software package for assessing surgical skills using the da Vinci telemanipulator system. . . .
JE Felger LW Nifong WR Chitwood SuffixJr (2002) ArticleTitleThe evolution of and early experience with robot-assisted mitral valve surgery. Surg Laparosc Endosc Percutan Technol 12 58–63
AG Gallagher RM Satava (2002) ArticleTitleVirtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures. Surg Endosc 16 1746–1752 Occurrence Handle10.1007/s00464-001-8215-6 Occurrence Handle1:STN:280:DC%2BD38jis1CisA%3D%3D
GB Hanna A Cuschieri (2000) ArticleTitleInfluence of two-dimensional and three-dimensional imaging on endoscopic bowel suturing. World J Surg 24 444–449 Occurrence Handle1:STN:280:DC%2BD3c7ntlOqtw%3D%3D Occurrence Handle10706917
JD Hernandez SD Bann Y Munz K Moorthy V Datta S Martin A Dosis F Bello A Darzi T Rockall (2002) ArticleTitleThe learning curve of a simulated surgical task using the da Vinci telemanipulator system. Br J Surg 89 IssueIDsuppl 17–18 Occurrence Handle10.1046/j.1365-2168.89.s.1.9_9.x
DB Johns JD Brewer NJ Soper (1996) ArticleTitleThe influence of three-dimensional video systems on laparoscopic task performance. Surg Laparosc Endosc 6 191–197 Occurrence Handle10.1097/00019509-199606000-00005 Occurrence Handle1:STN:280:BymA3s3pvFM%3D Occurrence Handle8743361
VB Kim WHH Chapman RJ Albrecht et al. (2002) ArticleTitleEarly experience with Telemanipulative Robot-assisted laparoscopic cholecystectomy using da Vinci. Surg Laparosc Endosc Percutan Technol 12 33–40
MD Mueller C Camartin E Dreher W Hanggi (1999) ArticleTitleThree-dimensional laparoscopy. Gadget or progress? A randomized trial on the efficacy of three-dimensional laparoscopy. Surg Endosc 13 469–472 Occurrence Handle10.1007/s004649901014 Occurrence Handle1:STN:280:DyaK1M3ksVOnuw%3D%3D Occurrence Handle10227944
Y Munz H Hernandez S Bann F Bello A Dosis S Martin K Moorthy T Rockall A Darzi (2002) ArticleTitleThe advantages of 3D visualization in surgical performance with the Da-Vinci telemaniputation system. J Soc Laparosc Surg 6 264
JA Shea MJ Healey JA Berlin JR Clarke PF Malet RN Staroscik JS Schwartz SV Williams (1996) ArticleTitleMortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg 224 609–620 Occurrence Handle10.1097/00000658-199611000-00005 Occurrence Handle1:STN:280:ByiD2svksV0%3D
N Taffinder S Smith J Mair et al. (1999) ArticleTitleCan a computer measure surgical precision? Reliability, validity and feasibility of the ICSAD. Surg Endosc 13 IssueIDsuppl 1 81 Occurrence Handle10.1007/s004649901107
LF Williams WC Chapman RA Bonau EC McGee RW Boyd JK Jacobs (1993) ArticleTitleComparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165 459–465 Occurrence Handle8480882
P Yohannes P Rotariu P Pinto AD Smith BR Lee (2002) ArticleTitleComparison of robotic versus laparoscopic skills: is there a difference in the learning curve? Urology 60 39–45 Occurrence Handle10.1016/S0090-4295(02)01717-X
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moorthy, K., Munz, Y., Dosis, A. et al. Dexterity enhancement with robotic surgery. Surg Endosc 18, 790–795 (2004). https://doi.org/10.1007/s00464-003-8922-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-8922-2