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Compensatory motion scaling for time-delayed robotic surgery

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A Correction to this article was published on 21 July 2020

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Abstract

Background

Round trip signal latency, or time delay, is an unavoidable constraint that currently stands as a major barrier to safe and efficient remote telesurgery. While there have been significant technological advancements aimed at reducing the time delay, studies evaluating methods of mitigating the negative effects of time delay are needed. Herein, we explored instrument motion scaling as a method to improve performance in time-delayed robotic surgery.

Methods

This was a robotic surgery user study using the da Vinci Research Kit system. A ring transfer task was performed under normal circumstances (no added time delay), and with 250 ms, 500 ms, and 750 ms delay. Robotic instrument motion scaling was modulated across a range of values (− 0.15, − 0.1, 0, + 0.1, + 0.15), with negative values indicating less instrument displacement for a given amount of operator movement. The primary outcomes were task completion time and total errors. Three-dimensional instrument movement was compared against different motion scales using dynamic time warping to demonstrate the effects of scaling.

Results

Performance declined with increasing time delay. Statistically significant increases in task time and number of errors were seen at 500 ms and 750 ms delay (p < 0.05). Total errors were positively correlated with task time on linear regression (R = 0.79, p < 0.001). Under 750 ms delay, negative instrument motion scaling improved error rates. Negative motion scaling trended toward improving task times toward those seen in non-delayed scenarios. Improvements in instrument path motion were seen with the implementation of negative motion scaling.

Conclusions

Under time-delayed conditions, negative robotic instrument motion scaling yielded fewer surgical errors with slight improvement in task time. Motion scaling is a promising method of improving the safety and efficiency of time-delayed robotic surgery and warrants further investigation.

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Acknowledgements

We thank Eric D Wirtz MD and Kelly Groom MD and other participants from the user study for their time. We wish to acknowledge and thank all the members of the Advanced Robotics and Controls Lab at UC San Diego for the intellectual discussions and technical help. We also acknowledge Dale Bergman and the Intuitive Surgical Research Division for their technical support of our dVRK system. Thank you to the United States Army Medical Research and Material Command (USAMRMC) and Telemedicine and Advanced Technology Research Center (TATRC) for their support, and for the UC San Diego Altman Clinical and Translational Research Institute (ACTRI) Galvanizing Engineering and Medicine Award that supported this work.

Funding

Rapid Innovation Fund (RIF) Award—FY17 AMEDD Advanced Medical Technology Initiative (AAMTI), United States Army Medical Research and Material Command (USAMRMC), Telemedicine and Advanced Technology Research Center (TATRC). UC San Diego, Altman Clinical and Translational Research Institute (ACTRI) Galvanizing Engineering and Medicine Award.

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Authors and Affiliations

  1. Division of Head and Neck Surgery, Department of Surgery, Moores Cancer Center, University of California San Diego, San Diego, CA, USA

    Ryan K. Orosco, Benjamin Lurie & Emily K. Funk

  2. Department of Cardiac Surgery, Japan Biodesign Program, The University of Tokyo, Tokyo, Japan

    Tokio Matsuzaki

  3. Department of Otolaryngology, Stanford University, Stanford, CA, USA

    Vasu Divi & F. Christopher Holsinger

  4. Division of Otolaryngology, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Steven Hong

  5. Department of Electrical and Computer Engineering, University of California San Diego, San Diego, CA, USA

    Florian Richter, Nikhil Das & Michael Yip

Authors
  1. Ryan K. Orosco
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  2. Benjamin Lurie
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  3. Tokio Matsuzaki
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  4. Emily K. Funk
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  5. Vasu Divi
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  6. F. Christopher Holsinger
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  7. Steven Hong
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  8. Florian Richter
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  9. Nikhil Das
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  10. Michael Yip
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Corresponding author

Correspondence to Ryan K. Orosco.

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Disclosures

Robotic instruments for the dVRK were provided through a collaboration with Intuitive Surgical. The company did not have a role in the design, implementation, or interpretation of this study. This work was funded, in part, through a Rapid Innovation Fund (RIF) Award through the United States Army Medical Research and Material Command (USAMRMC) and Telemedicine and Advanced Technology Research Center (TATRC). The views expressed are those of the authors and do not reflect the official policy or position of the US Army, Department of Defense, or the US Government. Dr. Orosco reports non-financial support from Intuitive Surgical, grants from United States Army Medical Research and Material Command (USAMRMC), Telemedicine and Advanced Technology Research Center (TATRC), grants from UC San Diego—Altman Clinical and Translational Research Institute (ACTRI), during the conduct of the study; In addition, Dr. Orosco has a patent Motion scaling for time-delayed robotic surgery pending. Dr. Matsuzaki reports grants from Japan Society for the Promotion of Science, during the conduct of the study. Dr. Funk reports grants from NIH/NIDCD during the conduct of the study. Dr. Richter reports non-financial support from Intuitive Surgical, during the conduct of the study; In addition, Dr. Richter has a patent Motion scaling for time-delayed robotic surgery pending. Dr. Yip reports non-financial support from Intuitive Surgical, grants from United States Army Medical Research and Material Command (USAMRMC), Telemedicine and Advanced Technology Research Center (TATRC), grants from UC San Diego—Altman Clinical and Translational Research Institute (ACTRI), during the conduct of the study; In addition, Dr. Yip has a patent Motion scaling for time-delayed robotic surgery pending. The other authors have nothing to disclose.

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This article was updated to correct Tokio Matsuzaki’s name in author listing.

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Orosco, R.K., Lurie, B., Matsuzaki, T. et al. Compensatory motion scaling for time-delayed robotic surgery. Surg Endosc 35, 2613–2618 (2021). https://doi.org/10.1007/s00464-020-07681-7

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