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Updated: Dec 18, 2025

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Handheld robotic needle holder training: slower but better.

Jing Feng1,2, Zhiyuan Yan3, Man Li1,2

  • 1Department of Urology, ZhongNan Hospital, Wuhan University, No. 169 Donghu Road, Wuhan, 430071, Hubei, China.

Surgical Endoscopy
|June 10, 2020
PubMed
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Novice surgeons using handheld robotic laparoscopic instruments showed a slower initial learning curve but achieved lower maximum force (MF) and suture tension after extensive training compared to conventional instruments. Maximum force is a sensitive measure of surgical skill progression.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Education
  • Robotics in Medicine

Background:

  • Handheld robotic laparoscopic instruments offer a blend of robotic dexterity and affordability, bridging a gap in surgical tooling.
  • The learning curve and efficacy of these novel instruments require thorough investigation for surgical training.

Purpose of the Study:

  • To compare the learning curves and performance metrics of novice surgeons using conventional versus handheld robotic laparoscopic instruments for suturing.
  • To evaluate the effectiveness of training protocols for new laparoscopic surgical tools.

Main Methods:

  • Forty novice surgeons were randomized into conventional (Group Conv) and robotic (Group Rob) instrument groups.
  • Participants underwent standardized laparoscopic suture training, with performance assessed via a force-sensing platform measuring maximum force (MF) and impulse (IMP).
Keywords:
Laparoscopic surgeryLearning curveMultiple freedom sutureRobotic needle holder

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  • Learning curves were generated and compared between the two groups based on MF and IMP data.

    • Main Results:

    • Both groups demonstrated decreased MF and IMP with increased training, indicating skill acquisition.
    • The conventional instrument group showed a faster initial decrease in MF and IMP compared to the robotic group.
    • After 13 hours of training, the robotic group exhibited significantly lower MF (P < 0.05) but no significant difference in IMP compared to the conventional group.

    Conclusions:

    • Training effectively reduces operator MF and IMP, potentially minimizing tissue damage with both instrument types.
    • While the robotic group required more training time to plateau, they achieved lower suture tension, suggesting improved control.
    • Maximum force (MF) is identified as a more sensitive indicator of performance improvement in laparoscopic suturing than impulse (IMP).