17 February 2012 Does a robotic scrub nurse improve economy of movements?
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Abstract
Objective: Robotic assistance during surgery has been shown to be a useful resource to both augment the surgical skills of the surgeon through tele-operation, and to assist the surgeon handling the surgical instruments to the surgeon, similar to a surgical tech. We evaluated the performance and effect of a gesture driven surgical robotic nurse in the context of economy of movements, during an abdominal incision and closure exercise with a simulator. Methods: A longitudinal midline incision (100 mm) was performed on the simulated abdominal wall to enter the peritoneal cavity without damaging the internal organs. The wound was then closed using a blunt needle ensuring that no tissue is caught up by the suture material. All the instruments required to complete this task were delivered by a robotic surgical manipulator directly to the surgeon. The instruments were requested through voice and gesture recognition. The robotic system used a low end range sensor camera to extract the hand poses and for recognizing the gestures. The instruments were delivered to the vicinity of the patient, at chest height and at a reachable distance to the surgeon. Task performance measures for each of three abdominal incision and closure exercises were measured and compared to a human scrub nurse instrument delivery action. Picking instrument position variance, completion time and trajectory of the hand were recorded for further analysis. Results: The variance of the position of the robotic tip when delivering the surgical instrument is compared to the same position when a human delivers the instrument. The variance was found to be 88.86% smaller compared to the human delivery group. The mean task completion time to complete the surgical exercise was 162.7± 10.1 secs for the human assistant and 191.6± 3.3 secs (P<.01) when using the robotic standard display group. Conclusion: Multimodal robotic scrub nurse assistant improves the surgical procedure by reducing the number of movements (lower variance in the picking position). The variance of the picking point is closely related to the concept of economy of movements in the operating room. Improving the effectiveness of the operating room can potentially enhance the safety of surgical interventions without affecting the performance time.
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Juan P. Wachs, Mithun Jacob, Yu-Ting Li, George Akingba, "Does a robotic scrub nurse improve economy of movements?", Proc. SPIE 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling, 83160E (17 February 2012); doi: 10.1117/12.911930; https://doi.org/10.1117/12.911930
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