A comparative human-centric analysis of virtual reality and dry lab training tasks on the da vinci surgical platform

There is a growing, widespread trend of adopting robot-assisted minimally invasive surgery (RMIS) in clinical care. Dry lab robot training and virtual reality simulation are commonly used to train surgical residents; however, it is unclear whether both types of training are equivalent or can be interchangeable and still achieve the same results in terms of training outcomes. In this paper, we take the first step in comparing the effects of physical and simulated surgical training tasks on human operator kinematics and physiological response to provide a richer understanding of exactly how the user interacts with the actual or simulated surgical robot. Four subjects, with expertise levels ranging from novice to expert surgeon, were recruited to perform three surgical tasks-Continuous Suture, Pick and Place, Tubes, with three repetitions-on two training platforms: (1) the da Vinci Si Skills Simulator and (2) da Vinci S robot, in a randomized order. We collected physiological response and kinematic movement data through body-worn sensors for a total of 72 individual experimental trials. A range of expertise was chosen for this experiment to wash out inherent differences based on expertise and only focus on inherent differences between the virtual reality and dry lab platforms. Our results show significant differences (p-value<0.05) between tasks done on the simulator and surgical robot. Specifically, robotic tasks resulted in significantly higher muscle activation and path length, and significantly lower economy of volume. The individual tasks also had significant differences in various kinematic and physiological metrics, leading to significant interaction effects between the task type and training platform. These results indicate that the presence of the robotic system may make surgical training tasks more difficult for the human operator. Thus, the potentially detrimental effects of virtual reality training alone are an important topic for future investigation.