A study on the dexterity of surgical robotic tools in a highly immersive virtual environment: assessing usability and efficacy

Robot-assisted minimally invasive surgery (RAMIS) has produced noticeable benefits for patients in the recent years [1], making it a favorable approach for a wide range of surgeries. The benefits of improving the dexterity of patient side manipulators to enable surgeons to perform more complex tasks are offset by the increased complexity of teleoperation and cognitive and physical effort on the operator side typically. A right balance between higher dexterity and intuitive control in teleoperation is yet to be defined. In this study, a dexterous, anthropomorphic primary master controller was deployed to assess and compare the efficiency of simulated anthropomorphic surgical instruments in an immersive surgical concept. Virtual surgical training tasks were built using a gaming software engine (Unity) and performed using simulated surgical tools with extended degrees of freedom (DoF) in the surgical shaft and gripper and compared with the standard da Vinci (DV) grasper. The motion of the tools were controlled using commercial inertial measurement unit (IMU) sensor-based devices attached to the user's arms and hands. This article summarizes results obtained from three studies with similar features but different levels of complexity, taken with both lay users with no experience in surgery or teleoperation and surgeons experienced in RAMIS. The results showed that more than 70% of users achieved better results using articulated tools but required more physical and mental effort for teleoperation.