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Teleoperated robot-assisted minimally-invasive surgery (RAMIS) offers manyadvantages over open surgery. However, there are still no guidelines fortraining skills in RAMIS. Motor learning theories have the potential to improvethe design of RAMIS training but they are based on simple movements that do notresemble the complex movements required in surgery. To fill this gap, wedesigned an experiment to investigate the effect of time-dependent forceperturbations on the learning of a pattern-cutting surgical task. Thirtyparticipants took part in the experiment: (1) a control group that trainedwithout perturbations, and (2) a 1Hz group that trained with 1Hz periodic forceperturbations that pushed each participant's hand inwards and outwards in theradial direction. We monitored their learning using four objective metrics andfound that participants in the 1Hz group learned how to overcome theperturbations and improved their performances during training without impairingtheir performances after the perturbations were removed. Our results present animportant step toward understanding the effect of adding perturbations to RAMIStraining protocols and improving RAMIS training for the benefit of surgeons andpatients.

Combining Time-Dependent Force Perturbations in Robot-Assisted Surgery Training