Comparison Between the PAF Rail and Surgical Instruments for Organ Manipulation in Laparoscopic and Robotic Surgery:...

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Soft Robotics

Background:

• Robotic-assisted partial nephrectomy (RAPN) and laparoscopic procedures require precise organ manipulation.
• Existing retraction instruments may pose risks to tissue integrity.
• Soft robotic devices offer potential for enhanced safety and efficacy.

Purpose of the Study:

• To evaluate the usability and workload of the pneumatically attachable flexible (PAF) rail.
• To assess the safety and tissue integrity associated with the PAF rail.
• To gather surgeon perceptions on using the PAF rail in simulated laparoscopic procedures.

Main Methods:

• Fourteen surgeons performed simulated retraction tasks using the PAF rail and standard instruments.
• Usability was measured using the System Usability Scale (SUS).
• Workload was assessed via NASA-TLX, qualitative feedback, and histopathological analysis.

Main Results:

• The PAF rail achieved high SUS scores, indicating good usability, especially for urology surgeons.
• Increased cognitive load and task completion times were observed, particularly in less experienced surgeons.
• Histopathological analysis revealed no additional tissue damage compared to conventional instruments.

Conclusions:

• The PAF rail demonstrates potential as a safe and effective tool for organ retraction in laparoscopic and robotic surgery.
• Good usability was confirmed, with no increased tissue damage.
• Further optimization is needed to address cognitive load and task efficiency for broader adoption.