Determination of the latency effects on surgical performance and the acceptable latency levels in telesurgery using the dV-Trainer® simulator

Abstract

The surgical performance deteriorates in an exponential way as the latency increases. The delay impact on instrument manipulation is mild at 0-200 ms, then increases from small to large at 300-700 ms, and finally becomes very large at 800-1,000 ms. Latencies ≤200 ms are ideal for telesurgery; 300 ms is also suitable; 400-500 ms may be acceptable but are already tiring; and 600-700 ms are difficult to deal with and only acceptable for low risk and simple procedures. Surgery is quite difficult at 800-1,000 ms, telementoring would be a better choice in this case.

Laparoscopic stereoscopic augmented reality: toward a clinically viable electromagnetic tracking solution

“…For example, Kumcu et al 30 reported deterioration in the performance and user experience beyond a 105-ms system latency. Xu et al 31 claimed that the impact of latency on instrument manipulations was mild in the 0 to 200-ms range and that a less than 200-ms latency was ideal for telesurgery. Perez et al 32 reported a measurable deterioration in the performance beginning at a latency of 300 ms. Based on these results, our measured system latency is within a clinically acceptable range.…”

Effect of latency training on surgical performance in simulated robotic telesurgery procedures

“…After informed consent had been obtained, the subjects were randomly split into two groups: the 400 ms delay group (G400; n = 5) and the 600 ms delay group (G600; n = 6). In the previous study, we demonstrated that 400-500 ms and 600-700 ms have a moderate and large impact, respectively, on instrument manipulation; training at these two latency levels would be representative (8).…”

“…Remote surgeons may be confronted with considerable time delay (500-900 ms) in the absence of dedicated fibre-optic lines (4)(5)(6)(7). We demonstrated in a previous study that simple telesurgical procedures remain possible with a delay up to 700 ms (8). However, the surgical performance deteriorates gradually as latency increases (8)(9)(10).…”

“…We demonstrated in a previous study that simple telesurgical procedures remain possible with a delay up to 700 ms (8). However, the surgical performance deteriorates gradually as latency increases (8)(9)(10). Training with latency may improve surgeons' performances in telesurgery, but little has been known about the latency training until now.…”

Teleoncology for gynecologic cancers

“…"Telesurgery" has since been an active area of technological research and development. Recent trials have attempted to assess the effect of communication latency on surgical performance [22][23][24], expand the scope of procedures achievable through telesurgery [24,25] and improve haptic feedback relayed to remote operators [26]. However, at present, telesurgery requires acquisition and maintenance of a robotic platform that is likely to be prohibitively expensive for rural treatment sites [27].…”