Category: Education, Simulation & Virtual Reality

MP19-19 - the position of forceps tip and arm joint position during vesicourethral anastomosis (VUA) by robotic surgery using optical motion capture

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective : Quantification of surgical skill may be beneficial for novice surgeons in mastering surgical techniques. In this study, we investigated the forceps tip and arm joint positions during vesicourethral anastomosis (VUA) by robotic surgery using optical motion capture.


Methods : Six skilled surgeons and six novice surgeons performed a VUA task under a dry box using the da Vinci Si in combination with a pelvic bladder urethral model. VUA was performed according to the operation method of each facility. Three-dimensional position information of the forceps tip, elbow, and hand was measured using optical motion capture. Evaluation parameters were the task time, speed/path length of the forceps tip, percentage of time that elapsed when the elbow was raised from the armrest by ≥5 cm, and working position/range. Each parameter was also examined for each direction of anastomosis (4-o’clock position: 5–7, 8–10, 2–4, and 11–1 o’clock directions).


Results : Underlined values in this section indicate significant differences. Compared with the novice surgeons, the skilled surgeons had a shorter task time (556 vs. 1380 s, respectively), faster right forceps speed (right: 2.58 vs. 1.39 cm/s, left: 2.08 vs. 1.83 cm/s, respectively), and shorter left forceps path length (right:  14.16 vs.19.08 , left: 11.24 vs. 25.02 m, respectively) . The percentage of time that elapsed when the elbow was raised was significantly shorter for skilled surgeons than novice surgeons (right: 1.19% vs. 6.03%, left: 0.76% vs. 2.48%, respectively). No difference was found in the working position or range between the two groups. In the directional examination, a significant difference was observed between the lift ratio of the left elbow and the velocity of the left forceps in the 2- to 4-o’clock direction. The same tendency was observed for the other directions.


Conclusions : In this study, we showed some of the differences in the technique of VUA. We would like to use the information obtained from this study to design an education course for novice surgeons.

Kenta Takayasu

graduate student
kansai medical university / urology and andrology
Hirakata, Osaka, Japan

Kenji Yoshida

Lecturer
Kansai Medical University
Hirakata, Osaka, Japan

Takao Mishima

Hirakata, Osaka, Japan

Masato Watanabe

hirakata, Osaka, Japan

Hidefumi Kinoshita

Hirakata, Osaka, Japan

Tadashi Matsuda

Hirakata, Osaka, Japan