title: Kinect technology for hand tracking control of surgical robots: technical and surgical skill comparison to current robotic masters.
abstract: BACKGROUND
  Current surgical robots are controlled by a mechanical master located away from the patient, tracking surgeon's hands by wire and pulleys or mechanical linkage. Contactless hand tracking for surgical robot control is an attractive alternative, because it can be executed with minimal footprint at the patient's bedside without impairing sterility, while eliminating current disassociation between surgeon and patient. We compared technical and technologic feasibility of contactless hand tracking to the current clinical standard master controllers.
  
  
  METHODS
  A hand-tracking system (Kinect™-based 3Gear), a wire-based mechanical master (Mantis Duo), and a clinical mechanical linkage master (da Vinci) were evaluated for technical parameters with strong clinical relevance: system latency, static noise, robot slave tremor, and controller range. Five experienced surgeons performed a skill comparison study, evaluating the three different master controllers for efficiency and accuracy in peg transfer and pointing tasks.
  
  
  RESULTS
  da Vinci had the lowest latency of 89 ms, followed by Mantis with 374 ms and 3Gear with 576 ms. Mantis and da Vinci produced zero static error. 3Gear produced average static error of 0.49 mm. The tremor of the robot used by the 3Gear and Mantis system had a radius of 1.7 mm compared with 0.5 mm for da Vinci. The three master controllers all had similar range. The surgeons took 1.98 times longer to complete the peg transfer task with the 3Gear system compared with Mantis, and 2.72 times longer with Mantis compared with da Vinci (p value 2.1e-9). For the pointer task, surgeons were most accurate with da Vinci with average error of 0.72 mm compared with Mantis's 1.61 mm and 3Gear's 2.41 mm (p value 0.00078).
  
  
  CONCLUSIONS
  Contactless hand-tracking technology as a surgical master can execute simple surgical tasks. Whereas traditional master controllers outperformed, given that contactless hand-tracking is a first-generation technology, clinical potential is promising and could become a reality with some technical improvements.
authors.affiliation: Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Room M7777, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
authors.forename: Yonjae
authors.initials: Y
authors.lastname: Kim
authors.forename: Simon
authors.initials: S
authors.lastname: Leonard
authors.forename: Azad
authors.initials: A
authors.lastname: Shademan
authors.forename: Axel
authors.initials: A
authors.lastname: Krieger
authors.forename: Peter C W
authors.initials: PC
authors.lastname: Kim
mesh_terms: D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D011930:Reaction Time; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*