Abstract
Each participant was given guidance on the main features of the endoscopy tasks to be carried out and how to operate the robotic system. Participants were allowed to manipulate the robotic system for 2 minutes to be familiar with their controls and setup. However, no time was allowed for any of the tasks, with or without the robot. Questions were allowed and answered before and during the tests in a general and direct manner, but no assistance was provided to handle the camera or endoscopic instruments during the trials. The same sequence of tasks was followed for each participant. In some tests, performance was evaluated with the dominant hand and the nondominant arm. In these tests, the dominant hand was initially assessed.
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The same robotic tools were always used for a specific test. During the trials, the surgeon was sitting. Each test was done twice, once by hand and once with the laparoscopic system with robotic assistance.
Handling tasks
Cylinder installation
This drill consisted of moving 10 plastic cylinders (5 × 5 mm) from an initial position to a predetermined position on the Peg Board. Time was recorded from start to finish, and each hand tested separately. Each correct cylinder was awarded 10 percentage points; 10 placements were recorded as 100% precision.
Bead Drop
In this test, there were 19 beads (10 × 4 mm) in a front container (50-mm opening). The task was to transfer 10 of the beads and release, 1 at a time, inside a final receptacle (15-mm opening). Each correct bead was awarded 10 percentage points; 10 rights falls were recorded as 100% precision.
Rope Passing
This task was to run a 25 × 0.3-cm rope using a manual technique. The rope was loose but stuck at both ends and had 10 different affixed points, 5 for the dominant instrument and 5 for the non-nominal instrument. To consider each hand separately, the rope was initially held in the direction of the commander and then towards the naive hand. The time was recorded from a starting position 5 cm from the rope to the moment the 2 instruments were taking the final 2 marks on the rope. Each understanding outside the specified marks decreased the ideal precise score (100%) under 5 percentage points.
Needle Limitation
For this test, we used disposable Hypodermic needle and its cap. The purpose of limiting the needle was to seize the two pieces from the floor of the training box. The only requirement was to limit the needle above the box floor. The test was first completed by handling the needle with the dominant arm and then with the unusual arm. The time from a starting point 5 cm from the needle and cap was recorded to the moment the needle and cap were coupled and kept by 1 instrument. The ideal precise score (100%) was reduced by 20 percentage points in every attempt to limit the needle.
Maintenance and Printing
We evaluated the ability to connect seam and require latex gloves using different identities. The following sounds and their order of use were used for the test: MH needle 2-0 silk, 18 cm; 4-0 silk CV-307, 15 cm; 6-0 C-1 polypropylene, 10 cm; and 7-0 polypropylene BV-1, 7 cm. The stitch had to go through 2 dotted points on the gloves. The size of the dots and the distance between the dots was relative to the size of the seam. The sizes were dot 1.5, 1.0, 0.75, and 0.5 mm, and the distances between the dots were 10, 5, 3, and 1 mm, for the 2-0, 4-0, 6-0, and 7-0, respectively. Time was recorded from the beginning of the stitch to the tie 3-knot to finish. The time taken to fit the needle into the needle driver was not considered. The nondominant hand was not assessed in these biennial tests. If the knot was loose, the ideal precise score (100%) was reduced by 20 percentage points; if the seam was broken, the score was reduced by 50 percentage points.
Running Suture
After the previous test, the rest was carried out by 10 points on the gloves to complete a running 4-grip. The size of the dots and the distance between them were relative to the size of the seam as stated for the combination task. The timer started when the needle on the needle driver had the operator, ready to take the first bite. The time to put the needle on the first batch was not considered. Each correct pass of the needle through a dot got 10 percentage points. If the seam was broken, the score was reduced by 50 percentage points.
Statistical analysis
Degree tests signed by (software package) were used to compare the 2 groups. P <.05 was considered significant.
Results
The results are presented. No significant differences were found between the dominant and unstable hand in either group. The average accuracy scores were 95% for manual manipulation and 97% for robotic system manipulation.
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