Abstract
Current surgical robotic systems are teleoperated and do not have force feedback. Considerable practice is required to learn how to use visual input such as tissue deformation upon contact as a substitute for tactile sense. Thus, unnecessarily high forces are observed in novices, prior to specific robotic training, and visual force feedback studies demonstrated reduction of applied forces. Simulation exercises with realistic suturing tasks can provide training outside the operating room. This paper presents contributions to realistic interactive suture simulation for training of suturing and knot-tying tasks commonly used in robotically-assisted surgery. To improve the realism of the simulation, we developed a global coordinate wire model with a new constraint development for the elongation. We demonstrated that a continuous modeling of the contacts avoids instabilities during knot tightening. Visual cues are additionally provided, based on the computation of mechanical forces or constraints, to support learning how to dose the forces. The results are integrated into a powerful system-agnostic simulator, and the comparison with equivalent tasks performed with the da Vinci Xi system confirms its realism.
Highlights
In open surgery, surgeons’ fingertips sensed tension on tissue and suture threads
We present novel contributions on the wire model with constraints on elongation and on the continuous modeling of the contacts
The robust collision detection and suture thread modeling enable suturing and knot-tying in an interactive and real-time simulation environment running on a standard personal computer
Summary
In open surgery, surgeons’ fingertips sensed tension on tissue and suture threads. A colour-coded force feedback based on the stress fields can be activated to alert surgeons when excessive force is applied during VR robotic suturing, in order to avoid excessive shearing forces These haptic cues illustrating the influence of trainees’ gestures on the mechanical balance can enhance training to adapt to the absence of tactile feedback in the non-virtual robotic surgery environment. To build such a simulator, the best possible trade-off between physics realism and latency has to be found. A realistic suture training simulator is demonstrated on basic exercises, where they can be compared to videos of training performed with a surgical robot
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