Initial experience using a robotic-driven laparoscopic needle holder with ergonomic handle: assessment of surgeons’ task performance and ergonomics

  • Juan A. Sánchez-Margallo
  • Francisco M. Sánchez-Margallo
Original Article



The objective of this study is to assess the surgeons’ performance and ergonomics during the use of a robotic-driven needle holder in laparoscopic suturing tasks.


Six right-handed laparoscopic surgeons with different levels of experience took part in this study. Participants performed a set of three different intracorporeal suturing tasks organized in ten trials during a period of five weeks. Surgeons used both conventional (Conv) and robotic (Rob) laparoscopic needle holders. Precision using the surgical needle, quality of the intracorporeal suturing performance, execution time and leakage pressure for the urethrovesical anastomosis, as well as the ergonomics of the surgeon’s hand posture, were analyzed during the first, fifth and last trials.


No statistically significant differences in precision and quality of suturing performance were obtained between both groups of instruments. Surgeons required more time using the robotic instrument than using the conventional needle holder to perform the urethrovesical anastomosis, but execution time was significantly reduced after training (\(p<\) 0.05). There were no differences in leakage pressure for the anastomoses carried out by both instruments. After training, novice surgeons significantly improved the ergonomics of the wrist (\(p<\) 0.05) and index finger (Conv: 36.381\(^{\circ }\pm 3.587^{\circ }\), Rob: 30.389\(^{\circ }\pm 4.100^{\circ }\); p = 0.024) when using the robotic instrument compared to the conventional needle holder.


Results have shown that, although both instruments offer similar technical performance, the robotic-driven instrument results in better ergonomics for the surgeon’s hand posture compared to the use of a conventional laparoscopic needle holder in intracorporeal suturing.


Laparoscopic surgery Robotic-driven needle holder Suturing checklist Ergonomics Data glove 



This work has been partially funded by the regional government of Extremadura, Spain, and the European Social Fund (PO14034).

Compliance with ethical standards

Conflict of interest

J. A. Sánchez-Margallo and F. M. Sánchez-Margallo have no conflict of interest or financial ties to disclose.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© CARS 2017

Authors and Affiliations

  1. 1.Department of Computer Systems and Telematics EngineeringUniversity of ExtremaduraBadajozSpain
  2. 2.Jesús Usón Minimally Invasive Surgical CentreCáceresSpain

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