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This pre-clinical study evaluated the impact of a novel force feedback (FFB) technology, integrated on a next-generation robotic system that allows surgeons to sense forces exerted at the instrument tips, on suturing performance by novice surgeons during RAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty-nine novice surgeons (&lt;\u200950 RAS cases in the last 5\u00a0years) were randomized into two groups with (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) or without (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914) FFB sensing. Participants performed interrupted stitches on ex vivo porcine bladder and running stitches on porcine aorta (Fig.\u00a01A) over four runs. Average forces applied, number of errors, time for exercise completion, and Robotic Anastomosis Competence Evaluation (RACE) technical skill ratings were compared using a three-way mixed-model ANOVA and applicable post hoc tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FFB sensing significantly lowered the mean force applied (bladder, 1.71 N vs 2.40 N,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.006; aorta, 1.80 N vs 2.53 N,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.006), average number of errors (bladder, 0.59 vs 1.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; aorta, 0.38 vs 1.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the time to completion (bladder, 659\u00a0s vs 781\u00a0s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002; aorta, 460\u00a0s vs 570\u00a0s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) (Fig.\u00a01C). The FFB group applied less tissue trauma with a higher RACE skill score (3.75 vs 3.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study showed that novice surgeons using FFB-enabled instruments completed suturing tasks using less force, with fewer errors, taking less time, and less tissue trauma during RAS. Future studies are required to better understand the impact of FFB technology on surgical performance and potential patient benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-024-11472-9","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T11:12:39Z","timestamp":1735557159000},"page":"1217-1226","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Novel force feedback technology improves suturing in robotic-assisted surgery: a pre-clinical study"],"prefix":"10.1007","volume":"39","author":[{"given":"Elliot L.","family":"Servais","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"Rashidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanshi","family":"Porwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Garibaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-6736","authenticated-orcid":false,"given":"Andrew J.","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"11472_CR1","doi-asserted-by":"crossref","unstructured":"Brown JD, Fernandez JN, Cohen SP, Kuchenbecker KJ. 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Andrew J. Hung, Elliot L. Servais, and Laila Rashidi are consultants for Intuitive Surgical. Priyanshi Porwal and Mark Garibaldi are employees of Intuitive Surgical.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}