Abstract

The da Vinci Surgical System is a robotic surgical platform that allows surgeons to operate their instruments remotely with improved visualization, dexterity, and ergonomics. However, physical separation from the instruments precludes the surgeon from using his or her sense of touch to interact with the operative environment. This lack of haptic (touch) feedback in existing robotic systems raises questions about the safety of robotic surgery and creates an additional challenge in training surgeons to use the robot.. Traditional surgical skill assessment relies on observation of a surgeon’s performance, a method that is both subjective and time consuming. The growing demand for robotic minimally invasive surgery has increased the need for objective methods of assessing technical skill for surgical training. Several prior studies have analyzed the kinematic motion of the robot to calculate performance metrics such as economy of motion and instrument speed. However, these metrics do not account for interactions between the instruments and the surgical environment. One possible method of objectively accounting for the quality of these interactions is to measure the transient mechanical vibrations of the robotic instruments. These vibrations primarily result from instrument contact with objects in the environment, such as collisions and needle hand-offs, with larger vibrations generally signifying rougher interactions. Abrupt movements of the surgical instruments also cause measurable vibrations. Our work on VerroTouch, a system for providing real-time auditory and haptic feedback of instrument vibrations, has shown that robotic instrument vibrations can easily be measured with low-cost accelerometers mounted on the patient-side robot. In this study, we aimed to determine whether this metric can be an indicator of skill level for a series of robotic surgical training tasks.