Abstract
Feedback from sensory modalities is crucial for the precise grasping of tissues during minimally invasive robotic surgery. The aims of the study are to determine the influence of visual and haptic feedback on the detection of threshold forces and to evaluate the applicability of the sensory integration model to a surgical grasping task. A sensorized surgical grasper and a fingertip haptic force feedback device were used. Three types of stimuli were presented (i.e. visual-alone, haptic-alone, and bimodal visual and haptic stimuli). Threshold forces of 100 mN and 87.5 mN were detected for visual and haptic feedback, respectively. When bimodal feedback was provided, the participants detected a threshold force of 75 mN. The threshold force for the bimodal condition was 28.6% lower than the visual-alone feedback and 15.4% lower than the haptic-alone feedback stimuli. Our bimodal condition results showed that there was a 13.1% difference between the experimental result and the predicted value from the sensory integration model. The threshold force discrimination was strongly influenced by the haptic force feedback. It is likely that the tissue stiffness can be more intuitively perceived through the direct force stimulation of the fingertip than just by visual observation alone. Cues like small deformations or changes in the grasping angles of the surgical tool are more difficult to interpret visually as compared to the haptic modality.
Highlights
M INIMALLY invasive surgery is getting more preferred over the traditional open surgery procedures due to its significant benefits for patients
3) We showed that haptic feedback has a stronger influence than visual feedback in the detection of threshold forces
No significant differences were found between haptic (Median = 87.5 mN) and bimodal (Median = 75 mN) feedback, U = 1768, z = -0.18, p = 0.86. These results indicate that the participants perceived the lower threshold forces better in both the haptic and bimodal feedback as compared to visual feedback
Summary
M INIMALLY invasive surgery is getting more preferred over the traditional open surgery procedures due to its significant benefits for patients. There are remaining challenges associated with minimally invasive surgery, such as the impaired perception of depth, lack of feedback for soft tissue palpation, and the limited view of the operative field [2]. Laparoscopic grasping tasks are examples of procedures that requires delicate manipulation of soft tissue [5]. Surgical sutures (i.e. diameter of less than 0.7 mm) require careful manipulation of the surgical grasper at small angles to prevent tissue damage and suture breakage due to high grasping forces and excessive pulling [6][7]. It has been recognized that the lack of haptic feedback system resulted in soft tissue damage and harm from excessively tight or loose stitches [6]
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