title: Dexterity enhancement with robotic surgery.
abstract: BACKGROUND
  The aim of this study was to quantify the extent of dexterity enhancement in robotic surgery as compared to laparoscopic surgery.
  
  
  METHODS
  Ten surgeons with varying laparoscopic suturing experience were asked to place three sutures on a suture pad. The sutures were placed laparoscopically, robotically with 2-D vision and robotically with 3-D vision. The da Vinci systems Application Programming Interface (API) was used for positional data. A validated motion analysis system was used for data retrieval for the laparoscopic task. Custom software was developed for data analysis.
  
  
  RESULTS
  Compared to laparoscopic suturing, when the task was undertaken robotically with 2-D vision there was a 20% reduction in the time taken but this was not significant (p = 0.07). There was a 55% reduction in the path traveled by the right hand (p = 0.01) and a 45% reduction in the path traveled by the left hand (p = 0.008). When the task was undertaken robotically with 3-D vision, there was a 40% reduction in the time taken (p = 0.01). There was a 70% reduction in the path traveled by right hand (p = 0.008) and a 55% reduction by the left hand (p = 0.08).
  
  
  CONCLUSIONS
  The presence of wristed instrumentation, tremor abolition, and motion scaling enhance dexterity by nearly 50% as compared to laparoscopic surgery. 3-D vision enhances dexterity by a further 10-15%. In addition, the presence of 3-D vision results in a 93% reduction in skills-based errors.
authors.affiliation: Department of Surgical Oncology and Technology, Imperial College, 10th Floor, QEQM Building, St. Marys Hospital, Praed Street, W2 1NY, London. k.moorthy@ic.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Moorthy
authors.forename: Y
authors.initials: Y
authors.lastname: Munz
authors.forename: A
authors.initials: A
authors.lastname: Dosis
authors.forename: J
authors.initials: J
authors.lastname: Hernandez
authors.forename: S
authors.initials: S
authors.lastname: Martin
authors.forename: F
authors.initials: F
authors.lastname: Bello
authors.forename: T
authors.initials: T
authors.lastname: Rockall
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002983:Clinical Competence; D006801:Humans; D010535:Laparoscopy; D011597:Psychomotor Performance; D012371:Robotics; D013514:Surgical Procedures, Operative; D013536:Suture Techniques; D014785:Vision, Ocular