Initial experience using a robotic-driven laparoscopic needle holder with ergonomic handle: assessment of surgeons’ task performance and ergonomics

• Published in: International journal for computer assisted radiology and surgery 2017-12, Vol.12 (12), p.2069-2077
• Main Authors: Sánchez-Margallo, Juan A., Sánchez-Margallo, Francisco M.
• Format: Article
• Language: English
• Subjects: Computer Imaging; Computer Science; Ergonomics; Health Informatics; Imaging; Laparoscopy; Leakage; Medicine; Medicine & Public Health; Original Article; Pattern Recognition and Graphics; Radiology; Robotics; Surgeons; Surgery; Training; Vision; Wrist; Yarn
• ISSN: 1861-6410; 1861-6429
• DOI: 10.1007/s11548-017-1636-z

Purpose The objective of this study is to assess the surgeons’ performance and ergonomics during the use of a robotic-driven needle holder in laparoscopic suturing tasks. Methods Six right-handed laparoscopic surgeons with different levels of experience took part in this study. Participants performed a set of three different intracorporeal suturing tasks organized in ten trials during a period of five weeks. Surgeons used both conventional (Conv) and robotic (Rob) laparoscopic needle holders. Precision using the surgical needle, quality of the intracorporeal suturing performance, execution time and leakage pressure for the urethrovesical anastomosis, as well as the ergonomics of the surgeon’s hand posture, were analyzed during the first, fifth and last trials. Results No statistically significant differences in precision and quality of suturing performance were obtained between both groups of instruments. Surgeons required more time using the robotic instrument than using the conventional needle holder to perform the urethrovesical anastomosis, but execution time was significantly reduced after training ( p < 0.05). There were no differences in leakage pressure for the anastomoses carried out by both instruments. After training, novice surgeons significantly improved the ergonomics of the wrist ( p < 0.05) and index finger (Conv: 36.381 ∘ ± 3 . 587 ∘ , Rob: 30.389 ∘ ± 4 . 100 ∘ ; p = 0.024) when using the robotic instrument compared to the conventional needle holder. Conclusions Results have shown that, although both instruments offer similar technical performance, the robotic-driven instrument results in better ergonomics for the surgeon’s hand posture compared to the use of a conventional laparoscopic needle holder in intracorporeal suturing.