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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2014

01-07-2014

Effects of robotic manipulators on movements of novices and surgeons

Authors: Ilana Nisky, Allison M. Okamura, Michael H. Hsieh

Published in: Surgical Endoscopy | Issue 7/2014

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Abstract

Background

Robot-assisted surgery is widely adopted for many procedures but has not realized its full potential to date. Based on human motor control theories, the authors hypothesized that the dynamics of the master manipulators impose challenges on the motor system of the user and may impair performance and slow down learning. Although studies have shown that robotic outcomes are correlated with the case experience of the surgeon, the relative contribution of cognitive versus motor skill is unknown. This study quantified the effects of da Vinci Si master manipulator dynamics on movements of novice users and experienced surgeons and suggests possible implications for training and robot design.

Methods

In the reported study, six experienced robotic surgeons and ten novice nonmedical users performed movements under two conditions: teleoperation of a da Vinci Si Surgical system and freehand. A linear mixed model was applied to nine kinematic metrics (including endpoint error, movement time, peak speed, initial jerk, and deviation from a straight line) to assess the effects of teleoperation and expertise. To assess learning effects, t tests between the first and last movements of each type were used.

Results

All the users moved slower during teleoperation than during freehand movements (F 1,9343 = 345; p < 0.001). The experienced surgeons had smaller errors than the novices (F 1,14 = 36.8; p < 0.001). The straightness of movements depended on their direction (F 7,9343 = 117; p < 0.001). Learning effects were observed in all conditions. Novice users first learned the task and then the dynamics of the manipulator.

Conclusions

The findings showed differences between the novices and the experienced surgeons for extremely simple point-to-point movements. The study demonstrated that manipulator dynamics affect user movements, suggesting that these dynamics could be improved in future robot designs. The authors showed the partial adaptation of novice users to the dynamics. Future studies are needed to evaluate whether it will be beneficial to include early training sessions dedicated to learning the dynamics of the manipulator.
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Metadata
Title
Effects of robotic manipulators on movements of novices and surgeons
Authors
Ilana Nisky
Allison M. Okamura
Michael H. Hsieh
Publication date
01-07-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3446-5

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