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Session: ePoster: Education, Training Assessment, and Practice Management 3 (Tue8)

EP1105 - Use of Force Feedback Associated with Reduced Force in Robotic-Assisted Colorectal Surgery

Tuesday, May 13, 2025
8:38 AM – 8:43 AM PT

    Quick Shot Presenter(s)

  • Grace C. Chang, DO

    MIS Colorectal Surgery Fellow
    MultiCare Health Network
    Tacoma, WA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Laila Rashidi, MD, FACS, FASCRS (she/her/hers)

    Colorectal Surgeon
    MutiCare Health Network
    Washington State University
    Seattle, Washington, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no relevant relationships with ineligible companies.

  • RM

    Robert Mostellar, n/a

    Senior Data Scientist
    Intuitive Surgical
    Sunnyvale, California, United States

    Disclosure information not submitted.

  • PP

    Poya Pourghaderi, DO

    Colorectal surgeon
    MultiCare hospital
    Tacoma, Washington, United States

    Disclosure information not submitted.

  • AS

    Ashwinram Suresh, Masters in Robotics

    Principal Systems Analyst
    Intuitive Surgical
    San Jose, California, United States

    Disclosure information not submitted.

  • JW

    James Wall, MD, FACS

    Associate Professor of Surgery, Associate Medical Officer
    Stanford University, Intuitive Surgical
    Palo Alto, California, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • GJ

    Gretchen Jackson, MD, PhD

    VIce President / Association Professor
    Intuitive Surgical / Vanderbilt University Medical Center
    Nashville, Tennessee, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Grace C. Chang, DO: This individual has no financial relationships with ineligible companies.
Laila Rashidi, MD, FACS, FASCRS: This individual has no relevant relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The lack of haptic feedback is a recognized limitation of robotic-assisted surgery. In 2024, the da Vinci 5 Surgical System was launched with Force Feedback sensors that measure multidirectional push and pull forces at tips of surgical instruments and transmit them to the robotic hand controllers. The purpose of this study was to examine whether the use of Force Feedback was associated with changes in force during robotic-assisted colorectal procedures.

Methods/Interventions: This study analyzed data from all colorectal surgery procedures performed on the da Vinci 5 surgical system using at least one Force Feedback instrument from system launch on March 29, 2024 to October 4 2024. Average force measures by Force Feedback setting (i.e., off, low, medium, and high) and instrument type were compared one-way analysis of variance (ANOVA) and post-hoc Tukey’s HSD tests. This analysis was performed on de-identified data from the da Vinci surgical system, and the study protocol was determined exempt by the WCG Institutional Review Board.

Results/Outcomes: A total of 265 colorectal procedures (168 (63.4%) colon resection; 97 (36.6%) rectal resection) met eligibility criteria and were performed by 60 unique surgeons with average robotic case experience of 951 cases. One Force Feedback instrument was used 199 cases (75.1%), two in 59 cases (22.3%), three in 6 cases (2.3%), and four in 1 case (0.4%). Average force was 2.14 Newtons (N) with Force Feedback set off (SD = 0.66), 1.92 N on low (SD = 0.62), 1.79 N on medium (SD = 0.57), and 1.77 N on high (SD = 0.57) (Figure 1), with statistically significant differences across settings (F-statistic = 9.87, p < 0.001). Post-hoc Tukey’s HSD tests further identified significant differences between off vs. high (p < 0.001), off vs. medium (p < 0.001), and off vs. low (p = 0.022) settings. Average force was 1.93 N for fenestrated bipolar forceps (SD = 0.61), 1.88 N for Cadiere forceps (SD = 0.64), and 1.45 N for
large needle driver (SD = 0.37) with differences being statistically significant (F-statistic = 18.21, p < 0.001), and Tukey’s HSD tests revealing significant differences between large needle driver vs. Cadiere forceps (p < 0.001) and large needle driver vs. fenestrated bipolar forceps (p < 0.001). Average force was 1.79 N for colon resections (SD = 0.58) and 2.03 N for rectal resections (SD = 0.64), with the difference being statistically significant (F-statistic = 24.28, p < 0.001).

Conclusion/Discussion: This study is one of the first to explore the impact of the Force Feedback in colorectal surgery. Use of Force Feedback was associated with significant decreases force even in highly experienced surgeons. The least force was observed when Force Feedback was set to high, and greater forces were observed when Force Feedback was set off, during rectal vs. colon resections, and when the surgeon used grasping instruments versus the needle driver. Future research will investigate whether decreased force affects clinical outcomes.