Electromyographic Activity Determines Task Difficulty for Robotic Laparoscopic Training Programs

INTRODUCTION In 2003 there were approximately 770,000 inguinal hernia repairs in the United States [1]. Over 75% of those hernia repairs were completed using mesh-based methodologies, and only 14% were completed laparoscopically. Hernia repair using the da Vinci® Surgical System (Intuitive Surgical Inc) has been gaining popularity due to motion scaling, greater range-of-motion and enhanced dexterity. Since hernia repair is a common procedure performed by general surgeons [2], incorporating a similar training task will help improve robotic training programs and the growth of robotic laparoscopy. In the present study such a novel task, mesh alignment, was developed and compared with two well-known and valid surgical tasks, needle passing (Fig.1a) and suture tying (Fig.1b) [3]. We assessed difficulty of these tasks using electromyography (EMG). We hypothesized that the task difficulty of the novel mesh alignment task would be similar to the other two.