Investigation of Hand Tremor Suppression by a Customized Passive Surgical Support Robot During Internal Limiting Membrane Peeling

Abstract

Purpose: To construct a quantitative evaluation system for hand tremor during internal limiting membrane (ILM) peeling and investigate changes in hand tremor attributable to the use of the customized passive surgical support robot. Methods: This analytical and experimental study developed a hand tremor evaluation system that synchronizes three elements: surgical microscope images, an artificial eye module with a force sensor to simulate ILM peeling, and microforceps with an inertial measurement unit. Two surgeons used this system to measure hand tremor during ILM peeling with and without the robot. Results: The horizontal, vertical, and combined vertical and horizontal components of hand tremor were 8.1 ± 6.1, 1.7 ± 1.8, and 8.5 ± 6.2 mG, respectively, in the no robot group. These components decreased to 7.2 ± 6.0, 1.5 ± 1.7, and 7.5 ± 6.1 mG, respectively, in the robot group. In particular, hand tremor was significantly suppressed by 11.9% for the horizontal component using the robot (p = 0.0006). Conclusion: The newly constructed system helps to quantitatively evaluate hand tremor during ILM peeling. The customized passive surgical support robot enables to decrease hand tremor during ILM peeling.