Impact of depth perception and movement freedom on performance in fine surgical tasks

This study aimed to evaluate the impact of new technology and depth perception on surgical tasks performance. Comparing to classical minimal access surgery, new robotic system allows to recover a 3D view and all degrees of freedom for instruments movement. To separately evaluate the benefit of robotic technology and the effect of depth perception, 60 medical students without any surgical experience were divided in 3 groups: one using the robotic system in 3D, another using robotic system in 2D, and the third using traditional laparoscopic technique (2D view). After a phase of familiarisation with the technique of their condition, subjects performed four specific fine motor tasks of increasing complexity. We measured the speed, the accuracy and their subjective impressions about their performance (satisfaction, self-confidence and difficulty). Our results show robotic system in 3D allows a better performance than classical laparoscopy in all tasks. More particularly, depth perception significantly improves performance in the easiest tasks (robotic system in 3D > robotic system in 2D and classical laparoscopy), while freedom for instruments movement seems to play a role in the most complex tasks (robotic system (2D or 3D) > classical laparoscopy). The subjective impressions analysis reproduces the differences observed from objective measures.