BACKGROUND: We conducted a comparative analysis of the first domestically produced Chinese surgical robot, 'MicroHand', laparoscopic, and barehanded approaches in tying surgical knots. METHODS: Four surgeons performed square or triple knots individually using the three approaches and documented the operational time, circumference, the bearable tension and action trajectory for each knot. RESULTS: MicroHand took more time than the barehanded method but nearly the same as with the laparoscope. The barehanded method generated the smallest knots among the three approaches and MicroHand produced smaller square knots than those by laparoscope. MicroHand and barehanded methods produced square knots displaying higher bearable tension than those produced by the laparoscope. For the action trajectory, MicroHand operated in a smaller space than that needed by the laparoscope. CONCLUSIONS: The square knots produced by MicroHand were tighter and more solid than those by laparoscope, although the triple knots generated by the two methods were similar. Also MicroHand required a smaller operational space than the laparoscope.
