Comparison of laparoscopic skills performance between standard instruments and two surgical robotic systems

被引:122
作者
Dakin, GF [1 ]
Gagner, M [1 ]
机构
[1] CUNY Mt Sinai Sch Med, Dept Surg, Div Laparoscop Surg, New York, NY 10029 USA
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2003年 / 17卷 / 04期
关键词
laparoscopic skills; laparoscopy; robotic surgery;
D O I
10.1007/s00464-002-8938-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Our objective was to compare the performance of laparoscopic tasks by surgeons using standard laparoscopic instruments and two surgical robotic systems. Methods: Eighteen surgeons performed tasks in a training box using three different instrument systems: standard laparoscopic instruments, the Zeus Robotic Surgical System, and the da Vinci Surgical System. Basic tasks included running a 100-cm rope, placing beads onto pins, and dropping cotton peanuts into cylinders; fine tasks included intracorporeal knot tying and running stitches with 4-0, 6-0, and 7-0 sutures. Time (in seconds) required and precision (number of errors) in performing each task were recorded. Analysis of variance with pair-wise comparisons using the Bonferroni method and Friedman's nonparametric test were used for statistical analysis. Results: Standard instruments performed significantly faster than either robotic system on the rope and bead tasks (p < 0.05), whereas da Vinci performed significantly faster than Zeus in all three basic tasks (p < 0.05). No significant difference in precision was found between standard instruments and the robotic systems on any of the basic tasks. Knot-tying and running-suture time were similar between standard instruments and da Vinci, which were significantly faster than Zeus (p < 0.05) for all suture sizes. The robotic systems were similar in precision for fine suturing tasks and were significantly more precise in knot tying (Zeus and da Vinci) and running sutures (da Vinci) than standard instruments (p < 0.05). Conclusions: Basic laparoscopic task performance is generally faster and as precise using standard instruments compared to either robotic system. In performing fine tasks, neither robotic system is faster than standard instruments, although they may offer some advantage in precision.
引用
收藏
页码:574 / 579
页数:6
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