Robotic dexterity: evaluation of three-dimensional monitoring system and non-dominant hand maneuverability in robotic surgery

There has been great progress in robotic surgical technology in recent years. The aim of this study was to objectively quantify robot-enhanced dexterity. To evaluate three-dimensional monitoring and non-dominant hand maneuverability using the da Vinci Surgical System, five surgeons were asked to thread the needle through all 11 holes on the model with handling robotic instrument. Three types of suturing were carried out. In task 1, sutures were placed using the dominant hand under 3D imaging; in task 2, suturing was performed using the dominant hand under 2D imaging; and in task 3, suturing was done with the non-dominant hand under 3D imaging. Each surgeon placed three sutures in completing each task. The time to successful completion, accuracy, and the opinion of the level of difficulty were recorded. All 45 tasks were completed. The time required to place each suture (mean ± SD) was as follows: 211.7 ± 50.5 s for task 1, 331.1 ± 121.2 s for task 2, and 237.1 ± 95.7 s for task 3. Task 1 took less time than task 2 (P = 0.02). There were no differences in the times between task 1 and task 3 (P = 0.19). Robotic suturing under 3D imaging is significantly faster than under 2D imaging, and robotic suturing using the non-dominant hand does not need significantly more time than with the non-dominant hand. Technology for robotic surgery could increase the manipulative abilities.