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Ebihara Y, Hirano S, Takano H, Kanno T, Kawashima K, Morohashi H, Oki E, Hakamada K, Urushidani S, Mori M. Technical evaluation of robotic tele-cholecystectomy: a randomized single-blind controlled pilot study. J Robot Surg 2023; 17:1105-1111. [PMID: 36602754 DOI: 10.1007/s11701-023-01522-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
Although robotic telesurgery is growing in popularity, the benefits of telesurgery compared to local surgery are unclear. This study aimed to evaluate the performance of robotic tele-cholecystectomy with a commercial line using the Saroa™ (Riverfield, Inc., Tokyo, Japan) system. The operation rooms of the Hokkaido University Hospital and Kushiro City General Hospital were connected using a best effort-type line (1 Gbps), with a distance of 250 km between the two hospitals. In this experimental single-blind randomized crossover trial, eight expert robotic surgeons performed robotic cholecystectomy in an artificial organ model using the Saroa™ system and were randomized to begin with either local surgery or telesurgery. All surgeons were assessed on task completion time, total path length of the right- and left- hand forceps and camera, Global Evaluative Assessment of Robotic Skills (GEARS), Global Operative Assessment of Laparoscopic Skills (GOALS), and System and Piper Fatigue Scale-12 (PFS-12). In all experiments, the communication environment was stable and the mean communication delay was 8 ms (3-31 ms). All tele-cholecystectomies were performed safely. There was no significant difference in completion time (P = 0.495), score of GEARS (P = 0.258), GOALS (P = 0.180), or PFS-12 (P = 0.528) between local surgery and telesurgery. The total path of the forceps tended to be longer in tele-cholecystectomy, particularly with significantly longer left-hand forceps total path length (P = 0.041). Robotic tele-cholecystectomy using a commercial line can be performed safely as same as local robotic surgery, but the total path of the left-hand forceps was prolonged in robotic tele-cholecystectomy due to overshoot. Therefore, a solution for overshooting will be required in the future.
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Affiliation(s)
- Yuma Ebihara
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.,Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-Ku, Sapporo, Hokkaido, 0608638, Japan
| | - Satoshi Hirano
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan. .,Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-Ku, Sapporo, Hokkaido, 0608638, Japan.
| | - Hironobu Takano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-Ku, Sapporo, Hokkaido, 0608638, Japan
| | | | - Kenji Kawashima
- Department of Information Physics and Computing School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Hajime Morohashi
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.,Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Eiji Oki
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.,Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - Kenichi Hakamada
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.,Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Masaki Mori
- Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.,Tokai University School of Medicine, Isehara, Japan
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