The impact of environmental noise on robot-assisted laparoscopic surgical performance

Siu, Ka-Chun; Suh, Irene H.; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

doi:10.1016/j.surg.2009.08.010

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Volume 147, Issue 1 , Pages 107-113, January 2010

The impact of environmental noise on robot-assisted laparoscopic surgical performance

Ka-Chun Siu, PhD
- Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE
- College of Public Health, University of Nebraska Medical Center, Omaha, NE
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE
- Reprint requests: Ka-Chun Siu, PhD, College of Public Health, University of Nebraska Medical Center, 985110 Nebraska Medical Center, Omaha, NE 68198-5110.
Irene H. Suh, MS
- Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE
- College of Public Health, University of Nebraska Medical Center, Omaha, NE
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE
Mukul Mukherjee, PhD
- Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE
Dmitry Oleynikov, MD
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE
Nick Stergiou, PhD
- Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE
- College of Public Health, University of Nebraska Medical Center, Omaha, NE
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE

Accepted 27 August 2009. published online 02 November 2009.

Background

An operating room is a noisy environment. How noise affects performance during robotic surgery remains unknown. We investigated whether noise during training with the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) would affect the performance of simple operative tasks by the surgeon.

Methods

Twelve medical students performed 3 inanimate operative tasks (bimanual carrying, suture tying, and mesh alignment) on the da Vinci Surgical System with or without the presence of noise. Prerecorded noise from an actual operating room was used. The kinematics of the robotic surgical instrument tips and the muscle activation patterns of the subjects were evaluated.

Results

We found noise effects for all 3 tasks with increases in the time to task completion (23%; P = .046), the total distance traveled (8%; P = .011) of the surgical instrument tips, and the muscle activation volume (87%; P = .015) with the presence of noise. We confirmed that the mesh alignment task was the most difficult task with the greatest time to task completion and the greatest muscle activation volume, whereas the suture tying task and the bimanual carrying could be considered the intermediate and the least difficult task, respectively. The noise effects were significantly greater while performing more difficult tasks.

Conclusion

Our findings demonstrated that noise degraded robotic surgical performance; however, the impact of noise on robotic surgery will depend on the level of difficulty of the task. Subsequent research is required to identify how different types of noise, such as random or rhythmic sounds, affect the performance of operative tasks using robots such as the da Vinci.