YOSHIMITSU Kitaro
   Department   Graduate School of Medical Science, Graduate School of Medical Science
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Enhancing surgical efficiency with an automated scrub nurse robot: a focus on automatic instrument insertion.
Journal Formal name:International journal of computer assisted radiology and surgery
Abbreviation:Int J Comput Assist Radiol Surg
ISSN code:18616429/18616410
Domestic / ForeginForegin
Volume, Issue, Page 20(10),pp.1975-1985
Author and coauthor YOSHIMITSU Kitaro†, MASAMUNE Ken, MIYAWAKI Fujio
Authorship Lead author
Publication date 2025/06/06
Summary PURPOSE:To address the chronic shortage of skilled scrub nurses, we propose the development of a scrub nurse robot (SNR). This paper describes the third-generation of our SNR, which implements the automatic insertion of surgical instruments (AISI). We focused on optimizing the instrument provision part of the instrument exchange task, which is a crucial role of the scrub nurse.METHODS:The third-generation SNR detects the moment when an operating surgeon withdraws an instrument after use from the trocar cannula, automatically conveys the next instrument to the cannula, and inserts only its tip into the cannula. Thereafter, the surgeon is required to grip the instrument and to push it fully into the cannula. This robotic function is designated as AISI. The following three combinations were compared: (1) third-generation SNR and surgeon stand-ins in a laboratory experiment, (2) three human scrub nurses and a skilled expert surgeon in three real surgical cases, (3) second-generation SNR and surgeon stand-ins in a laboratory experiment.RESULTS:The third-generation SNR and surgeon stand-ins were 53% slower and 34% faster, respectively, in targeting the instruments during the instrument exchange sequence compared with the actual OR nurse-surgeon pair and the second-generation SNR-stand-in pair. The average "eyes-off" time of the stand-ins assisted by the third-generation SNR was 0.41 s (0 s in 92 out of 138 trials), whereas that of the real surgeon in clinical cases had a mean of 1.47 (N = 138) (range, 0.69-7.24 s) when using the second-generation SNR.CONCLUSION:Third-generation SNR with AISI can enhance operative efficiency by contributing to smooth instrument exchange, which enhances the surgeon's ability to concentrate on a surgical procedure without interrupting the intraoperative surgical rhythm.
DOI 10.1007/s11548-025-03433-x
PMID 40478472