Abstract
Intraoperative palpation is a surgical gesture jeopardized by the lack of haptic feedback which affects robotic minimally invasive surgery. Restoring the force reflection in teleoperated systems may improve both surgeons' performance and procedures' outcome. A force-based sensing approach was developed, based on a cable-driven parallel manipulator with anticipated seamless and low-cost integration capabilities in teleoperated robotic surgery. No force sensor on the end-effector is used, but tissue probing forces are estimated from measured cable tensions. A user study involving surgical trainees (n = 22) was conducted to experimentally evaluate the platform in two palpation-based test-cases on silicone phantoms. Two modalities were compared: visual feedback alone and both visual + haptic feedbacks available at the master site. Surgical trainees' preference for the modality providing both visual and haptic feedback is corroborated by both quantitative and qualitative metrics. Hard nodules detection sensitivity improves (94.35 ± 9.1% vs 76.09 ± 19.15% for visual feedback alone), while also exerting smaller forces (4.13 ± 1.02 N vs 4.82 ± 0.81N for visual feedback alone) on the phantom tissues. At the same time, the subjective perceived workload decreases. Tissue-probe contact forces are estimated in a low cost and unique way, without the need of force sensors on the end-effector. Haptics demonstrated an improvement in the tumor detection rate, a reduction of the probing forces, and a decrease in the perceived workload for the trainees. Relevant benefits are demonstrated from the usage of combined cable-driven parallel manipulators and haptics during robotic minimally invasive procedures. The translation of robotic intraoperative palpation to clinical practice could improve the detection and dissection of cancer nodules.
Highlights
H APTIC sensation relates to the sense of touch and plays a crucial role in sensing – the perception of environmental information, and manipulation – the active modification of the environment [1]
We demonstrated that delivering haptic feedback to the users (1) improved the tumor detection rate, (2) decreased the applied forces on the tissues, and (3) diminished the perceived workload for the surgical trainees involved in the study
This paper introduced a new, simple and cost-effective approach for restoring the sense of touch during intracorporeal palpation, using a teleoperated cable-driven parallel manipulator, namely the CYCLOPS Data Acquisition System (CDAQS)
Summary
H APTIC sensation relates to the sense of touch and plays a crucial role in sensing – the perception of environmental information–, and manipulation – the active modification of the environment [1]. The sense of touch consists of a kinesthetic and a tactile component [2]. The kinesthetic information is fed back to muscles, tendons and joints as a reaction force whenever dynamic interactions with the environment occur. The tactile information is conveyed through specific nerve endings in the skin, known as mechanoreceptors, which detect shape, edges, temperature and texture of the probed object. Human touch perception is enabled by the kinesthetic-tactile synergy. Haptic devices, aimed at conveying the sense of touch to the human operator, have a wide variety of applications, ranging from space engineering, manufacturing and assembly, humancomputer interaction for rehabilitation, prosthetics and surgical robotics [3]
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