Robotics versus laparoscopy - an experimental study of the transfer effect in maiden users

20 subjects, with no prior surgical experience, performed three different surgical tasks in a standardized experimental setting, repeated four times with each of the RL and CL techniques. Speed and accuracy were measured. A cross-over technique was used to eliminate gender bias and the experience gained by carrying out the first part of the study.The task "tie a knot" was performed faster with the RL technique than with CL. Furthermore, shorter operating times were observed when changing from CL to RL. There were no time differences for the tasks of grabbing the needle and continuous suturing between the two operating techniques. Gender did not influence the results.The more advanced task of tying a knot was performed faster using the RL technique than with CL. Simpler surgical interventions were performed equally fast with either technique. Technical skills acquired during the use of CL were transferred to the RL technique. The lack of tactile feedback in RL seemed to matter. There were no differences between males and females.Conventional laparoscopic (CL) surgery may offer great advantages to patients but can be demanding for the surgeon because of several technical drawbacks. These limitations include 2-dimensional vision with less than optimal perception of depth, disturbance of the eye-hand-target axis, the fulcrum effect, rigid instruments with limited degrees of freedom and limited tactile feedback. These factors might attribute to the relatively long training period required before reaching a professional level [1,2].The da Vinci？ surgical system from Intuitive Surgical？ (Sunnyvale, CA, USA) has been available since 1998 and is still the only robotic surgical system available on the market approved for performing surgical interventions in humans. Several advantages with robot-assisted laparoscopy (RL) over CL have been identified: 3-dimensional visualization of the operative field with depth perception, additional degrees of freedom and downscaling of instr