Effects of robotic manipulators on movements of novices and surgeons.
Effects of robotic manipulators on movements of novices and surgeons.
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DOI：
10.1007/s00464-014-3446-5
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Hsieh MH
中科院分区：
文献类型：
--
作者：
Nisky I;Okamura AM;Hsieh MH
机器人辅助手术被广泛应用于许多手术，但到目前为止还没有充分发挥其潜力。基于人类运动控制理论，作者假设，主操作手的动力学对使用者的运动系统构成挑战，并可能损害操作能力和减慢学习速度。尽管研究表明，机器人的结果与外科医生的病例经验相关，但认知技能与运动技能的相对贡献尚不清楚。这项研究量化了达芬奇大师操纵器动力学对新手用户和经验丰富的外科医生动作的影响，并提出了可能对培训和机器人设计的启示。在报道的研究中，6名经验丰富的机器人外科医生和10名非医疗新手在两种情况下进行动作：远程操作达芬奇外科系统和徒手操作。将线性混合模型应用于9个运动学指标(包括终点误差、移动时间、峰值速度、初始急速和对直线的偏差)，以评估遥操作和专业知识的影响。为了评估学习效果，使用了每种类型的第一个和最后一个动作之间的t检验。所有受试者在远距离操作时的移动速度都比徒手移动时慢(F，9343=345；p<；0.001)。有经验的外科医生的错误比新手小(F1，14=36.8；p<；0.001)。运动的直线度取决于它们的方向(F7,9343=117；p<；0.001)。在所有条件下观察学习效果。新手用户首先学习这项任务，然后学习机械手的动力学。研究结果显示，对于极其简单的点对点动作，新手和有经验的外科医生之间存在差异。这项研究表明，机械手的动力学会影响用户的动作，这表明这些动力学可以在未来的机器人设计中得到改进。作者展示了新手用户对动态的部分适应。需要未来的研究来评估包括专门学习机械手动力学的早期培训课程是否有益。
Robot-assisted surgery is widely adopted for many procedures but has not realized its full potential to date. Based on human motor control theories, the authors hypothesized that the dynamics of the master manipulators impose challenges on the motor system of the user and may impair performance and slow down learning. Although studies have shown that robotic outcomes are correlated with the case experience of the surgeon, the relative contribution of cognitive versus motor skill is unknown. This study quantified the effects of da Vinci Si master manipulator dynamics on movements of novice users and experienced surgeons and suggests possible implications for training and robot design. In the reported study, six experienced robotic surgeons and ten novice nonmedical users performed movements under two conditions: teleoperation of a da Vinci Si Surgical system and freehand. A linear mixed model was applied to nine kinematic metrics (including endpoint error, movement time, peak speed, initial jerk, and deviation from a straight line) to assess the effects of teleoperation and expertise. To assess learning effects, t tests between the first and last movements of each type were used. All the users moved slower during teleoperation than during freehand movements (F1,9343 = 345; p < 0.001). The experienced surgeons had smaller errors than the novices (F1,14 = 36.8; p < 0.001). The straightness of movements depended on their direction (F7,9343 = 117; p < 0.001). Learning effects were observed in all conditions. Novice users first learned the task and then the dynamics of the manipulator. The findings showed differences between the novices and the experienced surgeons for extremely simple point-to-point movements. The study demonstrated that manipulator dynamics affect user movements, suggesting that these dynamics could be improved in future robot designs. The authors showed the partial adaptation of novice users to the dynamics. Future studies are needed to evaluate whether it will be beneficial to include early training sessions dedicated to learning the dynamics of the manipulator.
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