Abstract
Robot-assisted minimally invasive surgery (RAMIS) has produced noticeable benefits for patients in the recent years <xref ref-type="bibr" rid="ref1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[1]</xref> , making it a favorable approach for a wide range of surgeries. The benefits of improving the dexterity of patient side manipulators to enable surgeons to perform more complex tasks are offset by the increased complexity of teleoperation and cognitive and physical effort on the operator side typically. A right balance between higher dexterity and intuitive control in teleoperation is yet to be defined. In this study, a dexterous, anthropomorphic primary master controller was deployed to assess and compare the efficiency of simulated anthropomorphic surgical instruments in an immersive surgical concept. Virtual surgical training tasks were built using a gaming software engine (Unity) and performed using simulated surgical tools with extended degrees of freedom (DoF) in the surgical shaft and gripper and compared with the standard da Vinci (DV) grasper. The motion of the tools were controlled using commercial inertial measurement unit (IMU) sensor-based devices attached to the user’s arms and hands. This article summarizes results obtained from three studies with similar features but different levels of complexity, taken with both lay users with no experience in surgery or teleoperation and surgeons experienced in RAMIS. The results showed that more than 70% of users achieved better results using articulated tools but required more physical and mental effort for teleoperation.
Highlights
Invasive surgery (MIS) and its noticeable benefits for patients in terms of fast recovery makes it a popular choice for a wide range of surgeries
The results show a noticeable difference between the two-fingered da Vinci (DV) grasper tool and the 3 F anthropomorphic grasper, both in terms of duration and speed of performing the task
The user-experience form (UEF) demonstrated that the users had a preference for the DV tool for this type of pick-and-place task and that the 3 F grasper was deemed unnecessarily complex
Summary
Invasive surgery (MIS) and its noticeable benefits for patients in terms of fast recovery makes it a popular choice for a wide range of surgeries. RAMIS has overcome several identified MIS issues, such as fulcrum effect, surgeon’s physical tremor due to muscular fatigue, and hand-eye coordination. These improvements have made some types of surgery, previously impossible, routinely performed in hospitals [4]. The DV EndoWrist, with its three-axis joint resembling the dexterity of the human wrist, allows surgeons to perform dexterous tasks, otherwise difficult with rigid laparoscopic tools [5]. The number of DoF with more articulated and flexible tools as in [9] and [10], and a number of different research platforms for flexible access surgery have recently been developed, including highly articulated robotic probes [11], the multitasking platform [12], and two-module soft endoscopes [13] as well as other instruments for surgeries performed in constrained areas, such as the throat [14]. With a provision of increased instrument articulation, a more sophisticated primary controller is needed to meet the high number of DoF, as in [13]
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