Background: One of the most significant limitations of surgical robots has been their inability to allow
multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical
instruments. We report the initial experience with a novel two-headed da Vinci surgical robot
that has two collaborative modes: the “swap” mode allows two surgeons to simultaneously operate
and actively swap control of the robot’s four arms, and the “nudge” mode allows them to share control
of two of the robot’s arms.
Materials and Methods: The utility of the mentoring console operating in its two collaborative
modes was evaluated through a combination of dry laboratory exercises and animal laboratory
surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical
tasks were compared to results from single-surgeon and single-resident performance. Statistical
significance was determined using Student’s t-test.
Results: Collaborative surgeon-resident swap control reduced the time to completion of complex
three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci
(P < 0.01) and by 34% compared to single-resident operation (P < 0.001). While swap mode was
found to be most helpful during parts of surgical procedures that require multiple hands (such as
isolation and division of vessels), nudge mode was particularly useful for guiding a resident’s hands
during crucially precise steps of an operation (such as proper placement of stitches).
Conclusion: The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic
surgery and improves the performance of complex surgical tasks. The mentoring console has the potential
to improve resident participation in surgical robotics cases, enhance resident education in surgical
training programs engaged in surgical robotics, and improve patient safety during robotic surgery.
