Assistance by adaptative damping on a complex bimanual task in laparoscopic surgery

• Published in: International journal for computer assisted radiology and surgery Vol. 19; no. 5; pp. 929 - 938
• Main Authors: Nassar, A., Vérité, F., Pechereau, F., Vitrani, M. A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2024; Springer Nature B.V
• Subjects: Adult; Biomechanical Phenomena; Clinical Competence; Computer Imaging; Computer Science; Damping; Female; Health Informatics; Humans; Imaging; Internship and Residency; Kinematics; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Original Article; Pattern Recognition and Graphics; Performance enhancement; Radiology; Robotic Surgical Procedures - methods; Robotics; Robots; Surgery; Suture Techniques; Sutures; Task complexity; Task Performance and Analysis; Vision; Workload; Workloads; Bimanual tasks; Laparoscopic surgery; Comanipulation; Adaptative damping
• ISSN: 1861-6429; 1861-6410; 1861-6429
• DOI: 10.1007/s11548-024-03082-6

Purpose Laparoscopic surgery has improved outcomes in abdominal surgery, but presents kinematic restrictions for surgeons. Robotic comanipulation with adaptative damping has been investigated in simple laparoscopic tasks. The present protocol aimed to determine the contribution of adaptive damping in complex bimanual tasks approaching clinical setting. Methods Fourteen residents in general surgery performed three exercises, and for each three repetitions without (classic repetitions) and three with robotic assistance (robotic repetitions) in a randomised order. The exercises chosen were trajectory, modified Pea on a Peg and intracorporeal suture. Task performance, gesture performance, workload and impression were measured. Also, a semi-directed interview was performed to collect the participants’ feeling about companipulated robots and their potential application in clinical practice. Results Adaptative damping assistance did not impact task performance, but allowed an economy of movement in the non-dominant hand during suture exercise (distance 916 ± 500 mm in classic vs. 563 ± 261 mm in robotic, p  < 0.001). Perceived workload ( p  = 0.12) and user’s impression were not different between classic and robotic repetitions, except novelty ( p  < 0.001). Participants’ interviews revealed their interest for the robotic devices, particularly the gravity compensation, and were ready to use the adaptative damping provided an intermittent use, for example to dissect dangerous areas. Conclusion Adaptative damping applied by comanipulated robots does not influence the performance of the task, but improves the performance of the gesture itself, particularly for the non-dominant hand, and during the realisation of a complex task like suturing. For residents in digestive surgery, this assistance does increase workload, and they would use this help in the operating room under certain conditions.