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Robotic versus non-robotic instruments in spatially constrained operating workspaces: a pre-clinical randomized

Thomas P Cundy^1,2, Hani J Marcus^1,2, Archie Hughes-Hallett^1,2

¹Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.

BJU International

|November 11, 2014

Summary

In confined surgical spaces, 3-mm non-robotic instruments outperformed robotic options for suturing tasks. Robotic instruments showed higher boundary breach counts, indicating a need for optimization in restricted anatomical areas.

Keywords:

robot-assisted robotic spatial constraints suturing workspace

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Area of Science:

Minimally Invasive Surgery
Surgical Robotics
Laparoscopic Instrumentation

Background:

Surgical workspace constraints can impact instrument performance.
Robotic surgical systems offer potential advantages in dexterity but may face spatial limitations.
Evaluating instrument effectiveness in varying workspace sizes is crucial for optimizing surgical outcomes.

Purpose of the Study:

To compare the effectiveness of robotic versus non-robotic laparoscopic instruments in spatially constrained surgical workspaces.
To assess task performance and instrument workspace breaches across different instrument sizes and workspace volumes.

Main Methods:

Surgeons performed intracorporeal suturing tasks using 3-mm non-robotic, 5-mm robotic, and 8-mm robotic instruments.
Tasks were conducted within cylindrical workspaces of 4, 6, and 8 cm diameters (50, 113, and 201 cm³ volumes).
Objective task performance scores and instrument workspace breach counts were the primary outcome measures.

Main Results:

The 3-mm non-robotic instruments achieved the highest task performance scores across all workspace sizes.
Task performance significantly decreased in smaller workspaces (4 cm diameter).
Robotic instruments exhibited higher counts of workspace boundary breaches compared to non-robotic instruments.

Conclusions:

Smaller operating workspaces (<200 cm³) limit the performance of both robotic and non-robotic instruments.
For advanced bimanual tasks like suturing in confined spaces, 3-mm non-robotic instruments are currently better suited.
Further optimization of robotic instruments is necessary for them to demonstrate unique advantages in workspace-restricted anatomical areas.