A Tactile Sensation Assisted VR Catheterization Training System for Operator’s Cognitive Skills Enhancement

Yu Wang,Fan Yang,Yaxin Li,Cheng Ren,Zhihang Shi,Tao Yang

doi:10.1109/access.2020.2982219

Abstract

In the clinical vascular interventional surgery, experienced surgeons usually rely on visual feedback to reason tool-tissue interaction, because haptic forces are easily contaminated by frictions between the catheter and the introducer sheath, which brings difficulty in collision force perceptions. Thus, cognitive skills are highly demanded for novice surgeons to thoroughly interpret the relative positions between tool and tissue in images and make appropriate decisions about further catheter motions in case of collisions. In this paper, an operator’s cognitive skills training system has been introduced, which exploits the tactile sensation to reinforce the visualized spatial positions between catheter tip and vascular wall in the VR simulator. In cooperation with the collision alert module (CAM) in the VR simulator, the newly developed catheter manipulator can provide tactile sensations for novices when catheter tip is threaded beyond safety boundary, so that the VR exhibited tool-tissue interaction can be deliberately intensified. For demonstrating such tactile sensations adequate to strengthen visions, the system model has been established to facilitate the analysis in the perspective of operator’s kinesthetic perception. A series of experiments have been conducted at last and the results reveal that the catheter manipulator can not only realize the accurate catheter motions but also provide the enough tactile sensations for novices. Moreover, statistical data prove that subjects under cognitive trainings have developed the ability to interpret the relative spatial positions between catheter tip and vascular wall. Such findings support that the operator’s cognitive skills can be enhanced by the tactile reinforcement of VR visualized tool-tissue interaction.

Highlights

The vascular interventional surgery (VIS) is emerging as an alternative to treat cardiovascular and cerebrovascular diseases since it outperforms open surgery in aspects of small incisions, less pain and short recovery time
In terms of the task completion time, the data show that subjects training under mode 2 make much progress in aspect of the surgical proficiency with the help of the tactile sensation
The contrast between standard deviations of mode 1 and mode 2 was consistent with the above results. These findings provide substantial evidence to prove that skills acquisition under mode 2 was comparatively steady

Summary

Introduction

The vascular interventional surgery (VIS) is emerging as an alternative to treat cardiovascular and cerebrovascular diseases since it outperforms open surgery in aspects of small incisions, less pain and short recovery time. By taking advantage of a long flexible catheter, experienced interventionalists are capable of steering catheter to the target of interest with the help of image guidance. Such overwhelming superiority of VIS is obtained at the cost of narrow sight scope and indirect access to the anatomy [1]. Hundreds of clinical practices have been performed by these systems globally [4], [5] Both systems mainly consist of a catheter robotic arm at patient table and a remote physician console which keeps interventionalists away from radiation source

Methods

Results

Discussion

Conclusion