Robotics in Minimally Invasive Surgery: Superior to Human Assistance?

01/08/2002

A recent study addressed the gain of efficiency through the use of robotic systems, now a standard in a wide range of laparoscopic procedures.

The research at the Southwestern Center for Minimally Invasive Surgery focused on the widely held assumption that robot-assisted camera control (RACC) is superior to a human driver, especially in terms of quality of view and directional precision. It secondly set out to investigate the impact of RACC on long-term cost savings and surgeon efficiency.

A standardized laparoscopic nissen fundoplication was performed on twenty adult pigs, using a voice controlled robot (AESOP2002) for the RACC procedures, while the same surgical fellow was assisted by an experienced, skilled camera driver during the other half the procedures.

The results showed no significance in motion-related parameters. Robotic camera control, however, resulted in significantly less camera rotational motion. This improves the surgeon’s visual information procession workload, providing him with more stable images. The stress on motor procession capacities, i.e. the original focus, appears to be unaffected.

The research team concludes that ”robot camera control does not appear to have either a positive or a negative surgeon motion efficiency. Instead, it is 'just as good' as human control performed by an experienced, skilled camera driver”.

They caution, however, that more detailed studies are needed to assess efficiency further, exploring various subtasks. In addition to that, they note that carryover effects due to the use of the same surgeon in all of the procedures and the implementation of a “best-case-scenario”, i.e. a very skilled surgical assistant, in the human driver trials may have lead to some bias in the findings.

MEDICA.de, Source: Surg Endosc 2002 Jul 8; [epub ahead of print]

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