Tool-Tissue Interaction Forces in Glioma Surgery

Abstract

Objectives: Knowledge and understanding of optimal forces required for tissue handling in neurosurgery are fundamental to accomplishing the task effectively, and safely. Surgical simulation has shown that >50% of errors made by surgical trainees are due to the inappropriate use of force. Neurosurgical training in tool-tissue interaction force is predominantly taught through an apprenticeship model, in which experts supervise trainees and provide qualitative and subjective feedback, such as “be gentle” or “retract more.” Furthermore, in glioma surgery, the emphasis has remained on extent of resection; forces of surgical dissection, while emerging concept, have not been studied. Here, we define the forces in Newton (N), observed for different surgical tasks in glioma surgery comparing the force profiles of trainees to expert surgeons.