Electromyographic frequency response of robotic laparoscopic training

Robotic laparoscopic surgery has been shown to decrease task completion time, reduce errors, and decrease training time when compared to manual laparoscopic surgery. However, current literature has not addressed physiological effects, in particular muscle responses, to training with a robotic surgical system. We seek to determine the frequency response of electromyographic (EMG) signals of specific arm and hand muscles with training using the da Vinci Surgical System (dVSS). Eight right-handed medical students were trained in three tasks with dVSS over four weeks. These subjects, along with eight controls, were tested before and after training. EMG signals were collected from four arm and hand muscles during the testing sessions and the median EMG frequency and bandwidth were computed. Median frequency decreased, while frequency bandwidth increased, post-training for two of the three tasks. The results suggested that training reduces muscle fatigue as a result of faster and more deliberate movements. These changes occurred predominantly in muscles that were the dominant muscles for each task. An evaluation of the physiological demands of robotic laparoscopic surgery using electromyography can provide us with a meaningful quantitative way to examine performance and skill acquisition.