title: Differences in hand movements and task completion times between laparoscopic, robotically assisted, and open surgery: an in vitro study.
abstract: Surgical dexterity depends on economy and precision of movements, and this can be objectively measured using electromagnetic motion analysis. We have assessed the differences in hand movements and task completion times between open, laparoscopic and robotically assisted surgery during an exercise performed in vitro. A standard surgical exercise was performed using open, standard laparoscopic (SL) and robotically assisted laparoscopic (RAL) approaches. The total duration of the exercise was studied along with the number and duration of movements required to complete the exercise in each surgical modality. The time taken to complete the exercise was significantly longer in both the SL and RAL approaches when compared to the open route. However, it was found that RAL had significantly decreased number of movements (mean difference = 24 movements, P < 0.006) but a longer duration of each movement when compared to SL (mean difference = 0.13 s, P < 0.001). This study shows objectively that the exercise took longer to complete using the RAL approach than the standard open approach. However, RAL had more purposeful movements and required fewer movements to complete the exercise compared to SL.
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK. balasubramanil@doctors.org.uk.
authors.forename: Latha
authors.initials: L
authors.lastname: Balasubramani
authors.affiliation: Department of Gynaecological Oncology, Somerset Cancer Centre, Musgrove Park Hospital, Taunton, TA1 5DA, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Milliken
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
authors.forename: John H
authors.initials: JH
authors.lastname: Shepherd
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.|Department of Gynaecology, St George's Hospital, Blackshaw Road, London, SW17 OQT, UK.
authors.forename: Thomas E J
authors.initials: TE
authors.lastname: Ind
keywords: Laparoscopic; Motion analysis; Open surgery; Robotic surgery