June 27, 2022
endoscopic movements in robotic surgery
endoscopic movements in robotic surgery

Minimally invasive surgical robots offer many advantages, but still require surgeons to alternately control surgical instruments and endoscopes. This work aims to provide autonomous navigation of the endoscope during surgery. Autonomous endoscopic motion is based on kinematic tracking of surgical instruments and is integrated with the da Vinci Research Kit. A preclinical usability study was conducted by 10 urologists. They performed two ex vivo stereotactic renal bladder reconstructions using both traditional and autonomous endoscopic controls. The usability of the system was tested by asking participants to fill out a standard system usability scale.

In addition, the effectiveness of the method was assessed by analyzing the total procedure time and time using the instrument outside the field of view. The average system usability score exceeded a threshold generally identified as the limit for evaluating good usability (average score = 73.25 > 68). The mean total procedure time for autonomous endoscopic navigation was comparable to that of conventional controls (p = 0.85 > 0.05), but significantly reduced out-of-field time (p = 0.022 < 0.05). Our findings suggest that autonomous endoscopes will improve the usability of surgical systems and have the potential to become additional tailored tools for surgeons who can always control or move the endoscope autonomously.

To evaluate the autonomous endoscopic navigation system, both the user’s performance related to the conduct of the experiment and the post-hoc feedback on system usability were considered. The metrics we investigated were: (i) total execution time (t_tot) spent by each user performing an experimental version of orthopedic renal bladder reconstruction; (ii) Time out of field of view (t_out_FoV), which refers to the cumulative time (i.e., not visible in the image) with one or more of the two instruments out of the endoscopic field of view during the procedure