Assessing potential benefits of enhanced dexterity in laparoscopic surgery

In order to provide guidelines for the development and evaluation of advanced laparoscopic instrumentation (including teleoperated devices), we assessed the impact of the "keyhole" constraint on surgeons' ability to perform standardized pick-and-place and suturing tasks. We show that avoiding reversed hand and tool motions has a dramatic impact on pick-and-place performance, but adding degrees of freedom (DOFs) yields comparatively little benefit. In suturing, either avoiding the reversed motions or adding DOFs confers substantial benefit, and the benefits are additive.