Abstract
The introduction of Minimally Invasive Surgery (MIS) has revolutionised surgical care, considerably improving the quality of many surgical procedures. Technological advances, particularly in robotic surgery systems, have reduced the complexity of such an approach, paving the way for even less invasive surgical trends. However, the fact that haptic feedback has been progressively lost through this transition is an issue that to date has not been solved. Whereas traditional open surgery provides full haptic feedback, the introduction of MIS has eliminated the possibility of direct palpation and tactile exploration. Nevertheless, these procedures still provide a certain amount of force feedback through the rigid laparoscopic tool. Many of the current telemanipulated robotic surgical systems in return do not provide full haptic feedback, which to a certain extent can be explained by the requirement of force sensors integrated into the tools of the slave robot and actuators in the surgeon’s master console. In view of the increased complexity and cost, the benefit of haptic feedback is open to dispute. Nevertheless, studies have shown the importance of haptic feedback, especially when visual feedback is unreliable or absent. In order to explore the importance of haptic feedback for the surgeon’s master console of a novel teleoperated robotic surgical system, we have identified a typical surgical task where performance could potentially be improved by haptic feedback, and investigate performance with and without this feedback. Two rounds of experiments are performed with 10 subjects, six of them with a medical background. Results show that feedback conditions, including force feedback, significantly improve task performance independently of the operator’s suturing experience. There is, however, no further significant improvement when torque feedback is added. Consequently, it is deduced that force feedback in translations improves subject’s dexterity, while torque feedback might not further benefit such a task.
Highlights
Invasive Surgery (MIS) procedures are applied for the same purposes as open surgery procedures, but with the advantage of being less invasive
Note that the error with visual feedback only, (VF ), is always higher than the feedback conditions, including force feedback (VF + FF and VF + FF + TF ). This proves that feedback conditions, including force feedback, significantly reduced the exit point error and the maximum penetration depth across all subjects independent of their individual tendency, the addition of torque feedback to the haptic feedback does not imply any significant change
Once again a significant decrease of the exit point error and the maximum penetration depth is found for the two haptic feedback conditions when compared with only visual feedback VF for a significance level of αB < 0.0167
Summary
Invasive Surgery (MIS) procedures are applied for the same purposes as open surgery procedures, but with the advantage of being less invasive. Some benefits of MIS are reduced pain, trauma, risks of infection and haemorrhage, as well as a reduced hospital stay, significantly reducing overall costs (Mack 2001) and complications Despite these benefits, MIS is very demanding for surgeons, as (1) the field of view and workspace are limited; (2) there is only 2D vision (depth perception is lost); (3) direct hand contact is lost; (4) manipulation of the laparoscopic tools under modified hand–eye coordination must be trained. Robotic surgery has been increasingly performed in the last few years, especially for bariatric (Jacobsen et al 2003; Moser and Horgan 2004), urologic (Dasgupta et al 2005) and cardiothoracic surgery (Bodner et al 2004) Despite all these advantages, if the properties of the distal organs are not properly rendered to the surgeon, his/her performance can be severely degraded.
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