Teleoperated versus open needle driving: Kinematic analysis of experienced surgeons and novice users

During robotic teleoperation, the dynamics of the master manipulators and the control of remote-side instruments impose challenges on the motor system of the human operator, and may impact performance and learning. In teleoperated robot-assisted minimally invasive surgery, there is a clear correlation between patient outcomes and the surgeon´s case experience. However, the effect of the teleoperator on human motor skills and the relationship between these motor skills and patient outcomes are unknown. We used the da Vinci Research Kit, a custom research version of the da Vinci Surgical System, to compare teleoperated and open needle-driving movements of experienced da Vinci surgeons and novices. The experimental protocol consisted of structured but unconstrained needle driving trials repeated 80 times to allow for computational modeling of movement coordination and learning. Kinematic analysis showed that teleoperation increases trial time but reduces path length, that the trial times and path lengths of experienced surgeons are smaller than those of novices. In addition, there are significant differences in learning between experienced surgeons and novice users. Modeling of the movements and learning processes of experienced and novice surgeons may be used in the design of novel controllers that will expand robotic surgery capabilities and improve robot-assisted surgical skill acquisition.