Development of a Haptic Simulator for Laparoscopic Trocar Insertion Training

Abstract

<h3>Study Objective</h3> To create an effective haptic simulator for laparoscopic trocar insertion training. <h3>Design</h3> The haptic simulator is based on six degree-of-freedom parallel manipulator with a force sensor and attached standard trocar. To operate the device, the user applies a downward force on the trocar which displaces to provide force feedback, based on a virtual simulation of the tissue planes of the anterior abdominal wall. This type of design is called an admittance haptic device. The simulated tissue model has the same layers as real tissue and the thickness of the layers can be changed. <h3>Setting</h3> The simulator is intended to be used in simulation and training centers to provide an effective method for skills training. <h3>Patients or Participants</h3> N/A. <h3>Interventions</h3> This haptic simulator was developed using typical insertion force profiles through measurement of rotational and downward forces of novice and expert surgeons while placing trocars through a simulated anterior abdominal wall model. The simulator was validated using standard metrics for haptic simulators and its ability to replicate a typical insertion force profile. <h3>Measurements and Main Results</h3> A physical model was developed using published data on trocar insertion force metrics. The results show that regardless of the unique insertion technique of the human user, the recorded force profile (an experimental analog of what the subject feels) follows the expected force profile during trocar insertion, meaning the force felt is not dependent on the user movement but rather the applied force. <h3>Conclusion</h3> This abstract presents a novel haptic simulator for laparoscopic trocar insertion which can be shown to accurately simulate insertion through the anterior abdominal wall. We hope that further development of the prototype, including validation with human subjects, will yield a more effective training method than is currently available, ultimately leading to safer trocar insertions and improved patient outcomes during this critical step in all laparoscopic surgeries.