Adaptative damping assistance in bimanual laparoscopic surgery

Area of Science:

• Minimally Invasive Surgery
• Robotics in Medicine
• Surgical Skill Acquisition

Background:

• Laparoscopic surgery offers patient benefits but poses kinematic challenges for surgeons.
• Robotic comanipulation, sharing instrument control, can provide adaptive damping for movement stabilization.

Purpose of the Study:

• To evaluate the impact of adaptive damping assistance during a bimanual laparoscopic task.
• To assess its effect on gesture performance, task performance, and surgeon expertise emergence.

Main Methods:

• Eighteen surgery-naive subjects performed a Peg Transfer task.
• Tasks were repeated with and without robotic comanipulation (adaptive damping).
• Performance metrics included task score, hand oscillations, travelled distance, eye-tracking, and perceived workload (NASA TLX, UEQ).

Main Results:

• Adaptive damping significantly improved gesture performance by reducing tool oscillations for both dominant and non-dominant hands.
• No significant improvement was observed in overall task performance (Peg Transfer score).
• Eye-tracking indicated a deterioration in movements associated with expertise emergence, and perceived workload was high.

Conclusions:

• Robotic adaptive damping enhances gesture precision in laparoscopic tasks but does not improve overall task performance or facilitate expertise development.
• The assistance comes at the cost of increased perceived workload.
• Further investigation on clinical tasks with professional surgeons is warranted.