Manual vs Robotically Assisted Laparoscopic Surgery in the Performance of Basic Manipulation and Suturing Tasks


Objective to compare the surgical performance of manual laparoscopic instruments with robotic assistance with basic maneuvers and intraday timing in still-life models.

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Design A series of laparoscopic tasks were used to evaluate basic endoscopic movements and body weights: placing a cylinder on the Board of Peg, putting beads into containers, running a 25-cm rope, and applying a cap to a hypodermic needle. The incorporated knot connecting and running from   was assessed separately through predetermined points. The meanings used for these tasks were 2-0 and 4-0 silks and 6-0 and 7-0 polypropylene.

Players Twenty surgeons completed the task of laparoscopic tasks manually and then with a system that was too helpful. None previously used the robotic system.

Key Measures The time required to perform the tasks and accuracy.

Results The robotic system made movements of surgeons accurately reproduce and filter their hand tremors effectively. In the basic tasks, the robotic system had much longer operating times (P <.001). In the weighted tasks, the longer working times were for the use of the robotic system for 2-0 and 4-0 (P <.001) synchronous sizes. However, there were no significant time differences for 6-0 and 7-0 (P.07) amounts. Similar precision measurements were carried out for all tasks using robotic hand tools and systems. No significant differences were found between the performance of high-level laparoscopic surgeons and laparoscopic members.

Conclusions Laparoscopic maneuvering and joint synthesis is more rapid and precise when done manually when it is done with the robotic prototype system. These differences in speed are proportional to the size of the seam. Future generations of the robotic system could eliminate these differences.

LAPAROSCOPIC surgery requires a large number of small and precise tissue movements to be manipulated and weighted in a limited space.  This precision must be maintained by operation, despite the normal fabric of the human hand and the accompanying difficult fatigue and long surgeries . In addition, the surgical expansion of the surgical field increases tremors effects, requiring more dexterity and further running with the surgery, which in turn increases fatigue.

Robots can make quick, precise and repeated movements for long periods. In contrast to surgeons, there are no tremors or fatigue. Therefore, the application of robotics to laparoscopic surgery may reduce some of the barriers to providing rapid and accurate movements, rather than eliminating them, particularly in long operations.

We compared the capacity of laparoscopic surgeons to a protocol of basic manipulation skills and to perform manual tasks with traditional laparoscopic instruments with a prototype laparoscopic system with robotic assistance.

Methods and Experimental design

20 surgeons participated in the study: 8 staff surgeons, 10 surgical members, and 2 surgical residents. Each staff surgeon had more than 100 laparoscopic surgeries, and more than 50 of the members carried out more than 50, while the remaining 6 members made between 25 and 50, while the surgical residents made less than 25.

All participants were members of the Minimally Invasive Surgery Center. These included laparoscopic staff surgeons, laparoscopic surgical members, general surgical members, and surgical residents. All surgeons were asked to complete a standardized laparoscop skills protocol. Initially they made the laparoscopic instruments manually handled and then with a laparoscopic system with robotic assistance. A number of tests were selected to evaluate their basic laparoscopic and incorporation weighting skills. Some of these tests have been changed from previous reports.

Experimental arrangement

The same setup was used for each test. We used basic aerospace equipment. The 3-chip video camera was connected to a 10-mm laparoscope, 30 °, and the image was displayed on 14-in-force monitoring. A laparoscopic training box was placed on a 50-cm high stand, and the surgeon was sitting on a chair with hand supports. All hand laparoscopic drills were executed using 5-mm disposable. The hand laparoscopic disturbance tests were carried out using a set of 5-mm laparoscopic needle drivers.

All robotic tests were carried out using the instruments developed by the manufacturer. The robotic system has 3 robotic weapons. One hand handles the camera and handles the other 2 different surgical instruments. For our experiment, we used 3-mm driving drivers. The surgeon handles these instruments through 2 configured controllers and a mechanism similar to those of regular laparoscopic needle drivers. The system has a feature that can scale the movements of regulators. Therefore, the surgeon can make wider movements and the robotic instruments moving within a narrow rim. This scaling element was determined by a 4: 1 proportion of our experiment. The camera is controlled by a system of action or three feet. In this way, the surgeon has direct control over the optical field and movement of instruments. The plastic molds used for the tests were customized.

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