Effects of network delay on training for telesurgery

Telesurgery is defined as robotic surgery performed over a distance using a communication link. Methods of training for telesurgery are unknown. We investigated whether trainees perform better with latencies at the outset (700 ms) or with zero latency and a training ramp (0, 350, 700 ms). Four test exercises were conducted. Performance of the groups was compared for the different delay settings. Straight cut and grasp steadiness exercises showed no significant difference except at 700 ms versus 0 ms (p<0.05). In object placement, differences occurred in the lower latencies (700 ms versus 0 ms; 700 ms versus 350 ms; p<0.05), but the groups were not different at the end of the trial (700 ms versus 700 ms). A Fitts´ law exercise showed no difference in performance between the groups at 700 ms. In conclusion, training for telesurgery may be equally effective with full latency at the outset or by using a training ramp.