Development of a Virtual-Reality Simulator for Performance and Usability Assessment in Hybrid Robotic Laparoscopy

Abstract

Introduction: Robotically Assisted Surgical Systems have shown rapid growth in the last years. Yet, they are still facing several challenges that increase the cost and complexity of such systems. Therefore, the Hybrid Robotic-Assisted Laparoscopy has been developed that aims to investigate the degree of robotization in surgical interventions. However, there is a need for evaluation of the usability and user performance during the development of such Hybrid Robotic-Assisted Laparoscopy systems. Method: A Virtual Reality Simulator was developed with four different tasks to assess and evaluate distinct criteria for usability and surgeon performance. In the first pilot study, 14 participants completed the tasks three times using different combinations of tools. The first combination consists of two conventional laparoscopic instruments (i.e., conventional setup), the second one of two haptic input devices used to control the motion of two kinematically simulated robotic arms (i.e., robotic setup), and the third scenario combines these two previous approaches by assigning a haptic input device and a conventional laparoscopic instrument to the two hands of the operator (i.e., hybrid setup). Results: The results of repeated measure Analysis of Variance indicate that a fully robotic setup leads to better performance metrics and improved ratings in the gathered subjective data. Additionally, the hybrid setup resulted in better performance compared to the fully conventional setup. Finally, the results did not report any significant difference in performance between the fully robotic and the hybrid setup.