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Published on: November 14, 2015
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Assistance by adaptative damping on a complex bimanual task in laparoscopic surgery.
A Nassar1, F Vérité2, F Pechereau2
1Institut des Systèmes Intelligents et de Robotique, Sorbonne Universités, 4, Place Jussieu, 75005, Paris, France. alexandra.nassar@free.fr.
Summary
Robotic comanipulation with adaptive damping improves surgical gesture economy, especially for the non-dominant hand in complex tasks like suturing. Surgeons found it beneficial for specific applications, though overall task performance was not significantly impacted.
Area of Science:
- Minimally Invasive Surgery
- Robotic Surgery
- Surgical Simulation
Background:
- Laparoscopic surgery offers improved patient outcomes but has kinematic limitations.
- Robotic comanipulation with adaptive damping has shown promise in simpler laparoscopic tasks.
- Evaluating adaptive damping in complex, bimanual tasks is crucial for clinical application.
Purpose of the Study:
- To assess the impact of adaptive damping in robotic comanipulation during complex bimanual laparoscopic tasks.
- To determine if adaptive damping affects task performance, gesture efficiency, workload, and surgeon perception.
- To explore the potential clinical utility and surgeon acceptance of adaptive damping in real-world surgical scenarios.
Main Methods:
- Fourteen general surgery residents performed three standardized laparoscopic exercises (trajectory, Pea on a Peg, intracorporeal suture).
- Each exercise was repeated three times with and three times without robotic assistance (adaptive damping) in a randomized order.
- Performance metrics, perceived workload, user impression, and qualitative feedback via interviews were collected.
Main Results:
- Adaptive damping did not significantly alter overall task performance.
- A significant economy of movement was observed in the non-dominant hand during suturing with adaptive damping (916±500 mm vs. 563±261 mm, p<0.001).
- Perceived workload and general impression remained similar, with novelty being the main differentiator (p<0.001); surgeons expressed interest in intermittent use for specific challenging maneuvers.
Conclusions:
- Robotic comanipulation with adaptive damping enhances gesture performance, particularly for the non-dominant hand in complex tasks like suturing, without negatively impacting overall task completion.
- While not increasing workload, surgeons indicated a willingness to use adaptive damping intermittently for specific, high-risk surgical maneuvers.
- This technology shows potential for improving surgical precision and efficiency in advanced laparoscopic procedures.
