Combining Time-Dependent Force Perturbations in Robot-Assisted Surgery Training

Abstract

Teleoperated robot-assisted minimally-invasive surgery (RAMIS) offers many advantages over open surgery. However, there are still no guidelines for training skills in RAMIS. Motor learning theories have the potential to improve the design of RAMIS training but they are based on simple movements that do not resemble the complex movements required in surgery. To fill this gap, we designed an experiment to investigate the effect of time-dependent force perturbations on the learning of a pattern-cutting surgical task. Thirty participants took part in the experiment: (1) a control group that trained without perturbations, and (2) a 1Hz group that trained with 1Hz periodic force perturbations that pushed each participant's hand inwards and outwards in the radial direction. We monitored their learning using four objective metrics and found that participants in the 1Hz group learned how to overcome the perturbations and improved their performances during training without impairing their performances after the perturbations were removed. Our results present an important step toward understanding the effect of adding perturbations to RAMIS training protocols and improving RAMIS training for the benefit of surgeons and patients.

A New Power Law Linking the Speed to the Geometry of Tool-Tip Orientation in Teleoperation of a Robot-Assisted Surgical System

“…However, it is important to note that clinical procedures involve more complex movements than what we studied here. They also involve time-dependant perturbations, such as the movement of the beating heart, and visual remapping due to tool or camera viewpoint misalignment [51], all of which could affect task performance [52], [53] and surgical outcome. To design virtual fixtures and autonomous surgical assistance with the help of motor invariants such as the power law that we report here, future studies are needed to test the effect of dynamic and visual perturbations on the parameters of the power law, and its applicability to more complex movements in contact with tissue.…”