Comparison of the da Vinci Xi and hinotori surgical robotic systems using a training model: an ex vivo study.

Robotic-assisted surgery is widely adopted in urology, but there is little comparative data between established and newly introduced platforms. We used an ex vivo training model to compare task performance and subjective workload between the widely-established da Vinci Xi system and the hinotori system, which was developed in Japan. In this prospective crossover study, 16 urologists performed three standardized tasks (camera manipulation and grasping, cutting, and suturing with knot tying) under three robotic conditions: using da Vinci Xi with finger clutch, using da Vinci Xi without finger clutch, and using hinotori. Task completion time was recorded for each trial, and subjective workload was assessed after every task using the weighted NASA Task Load Index (NASA-TLX). Median task completion times tended to be longer with hinotori than with either of the da Vinci Xi conditions, although no significant differences were observed between the three systems for any of the tasks. In contrast, weighted NASA-TLX scores were significantly higher with hinotori than with the da Vinci Xi with finger clutch for the camera/grasping and suturing tasks, whereas no significant differences were detected between hinotori and the da Vinci Xi without finger clutch. The hinotori system demonstrated task performance that was comparable to that by the da Vinci Xi platform, while subjective workload was higher relative to the da Vinci Xi when the finger clutch function was used. Our results suggest that surgeon workload during robotic surgery may be strongly influenced by console-specific ergonomic features, particularly the presence or absence of a finger clutch function.