Top

Published in:

01-04-2013

The role of tactile feedback in grip force during laparoscopic training tasks

Authors: Christopher R. Wottawa, Jeremiah R. Cohen, Richard E. Fan, James W. Bisley, Martin O. Culjat, Warren S. Grundfest, Erik P. Dutson

Published in: Surgical Endoscopy | Issue 4/2013

Abstract

Background

Laparoscopic minimally invasive surgery has revolutionized surgical care by reducing trauma to the patient, thereby decreasing the need for medication and shortening recovery times. During open procedures, surgeons can directly feel tissue characteristics. However, in laparoscopic surgery, tactile feedback during grip is attenuated and limited to the resistance felt in the tool handle. Excessive grip force during laparoscopic surgery can lead to tissue damage. Providing additional supplementary tactile feedback may allow subjects to have better control of grip force and identification of tissue characteristics, potentially decreasing the learning curve associated with complex minimally invasive techniques.

Methods

A tactile feedback system has been developed and integrated into a modified laparoscopic grasper that allows forces applied at the grasper tips to be felt by the surgeon’s hands. In this study, 15 subjects (11 novices, 4 experts) were asked to perform single-handed peg transfers using these laparoscopic graspers in three trials (feedback OFF, ON, OFF). Peak and average grip forces (newtons) during each grip event were measured and compared using a Wilcoxon ranked test in which each subject served as his or her own control.

Results

After activating the tactile feedback system, the novice subject population showed significant decreases in grip force (p < 0.003). When the system was deactivated for the third trial, there were significant increases in grip force (p < 0.003). Expert subjects showed no significant improvements with the addition of tactile feedback (p > 0.05 in all cases).

Conclusion

Supplementary tactile feedback helped novice subjects reduce grip force during the laparoscopic training task but did not offer improvements for the four expert subjects. This indicates that tactile feedback may be beneficial for laparoscopic training but has limited long-term use in the nonrobotic setting.

Feussner H, Siewert JR (2001) Reduction of surgical access trauma: reliable advantages. Der Chirug Mar 72:236–244

Jacobs JK, Goldstein RE (1997) Laparoscopic adrenalectomy: a new standard of care. Ann Surg 225:495–501PubMedCrossRef

Lanfranco AR, Castellano AE, Desai JP, Meyers WC (2004) Robotic surgery: a current perspective. Ann Surg 239:14–21PubMedCrossRef

Oehler MK (2009) Robot-assisted surgery in gynaecology. Aust N Z J Obstet Gynaecol 49:124–129PubMedCrossRef

Kontarinis DA, Son JS, Peine W, Howe RD (1995) A tactile shape sensing and display system for teleoperated manipulation. Proc IEEE Int Conf Robot Autom 1:641–646

Franco ML, King CH, Culjat MO, Lewis CE, Bisley JW, Holmes EC, Grundfest WS, Dutson EP (2009) An integrated pneumatic tactile feedback actuator array for robotic surgery. Int J Med Robot 5:13–19PubMedCrossRef

King CH, Culjat MO, Franco ML, Lewis CE, Dutson EP, Grundfest WS, Bisley JW (2009) Tactile feedback induces reduced grasping force in robotic surgery. IEEE Trans Haptics 2:103–110CrossRef

Burdea GC (1996) Force and touch feedback for virtual reality. Wiley, New York, pp 3–4

Okamura AM (2009) Haptic feedback in robot-assisted minimally invasive surgery. Curr Opin Urol 19:102–107PubMedCrossRef

10.

Cavusoglu MC, Williams W, Tendick F, Sastry SS (2003) Robotics for telesurgery: second-generation Berkeley/UCSF laparoscopic telesurgical workstation and looking towards the future applications. Ind Rob 30:22–29CrossRef

11.

Lee S, Lee J, Choi DS, Kim M, Lee CW (1999) The distributed controller architecture for a masterarm and its application to teleoperation with force feedback. In: Proceedings of the IEEE international conference on robotics and automation, vol 1, pp 213–218

12.

Brooks FP, Ouh-Young M, Battert JJ, Kilpatrick PJ (1990) Project GROPE—haptic displays for scientific visualization. Comput Graph 24:177–185CrossRef

13.

Cai Y, Ishii M, Sato M. (1996) A human interface device for CAVE size virtual workspace. In: IEEE international conference on systems, man, and cybernetics, Beijing, pp 2084–2089

14.

Baumann R, Clavel R. (1998) Haptic interface for virtual reality-based minimally invasive surgery simulation. In: Proceedings of the 1998 IEEE international conference on robotics and automation, Leuven, pp 381–386

15.

King CH, Higa AT, Culjat MO, Han SH, Bisley JW, Carman GP, Dutson EP, Grundfest WS (2007) A pneumatic haptic feedback actuator array for robotic surgery or simulation. In: Proceedings of medicine meets virtual reality 15, Long Beach, pp 217–222

16.

Bethea BT, Okamura AM, Kitagawa M, Fitton TP, Cattaneo SM, Gott VL, Baumgartner WA, Yuh DD (2004) Application of haptic feedback to robotic surgery. J Laparoendosc Adv Surg Tech 14:191–195CrossRef

17.

Bouzit M, Popescu G, Burdea G, Boian R (2002) The Rutgers Master II-ND force feedback glove. In: 10th symposium on haptic interfaces for virtual environment and teleoperator systems, Orlando, p 145

18.

Nakamura M, Jones L (2003) An actuator for the tactile vest: a torso-based haptic device. In: Proceedings of the IEEE symposium on haptic interfaces for virtual environment and teleoperator systems, Los Angeles

19.

Fan RE, Culjat MO, King CH, Franco ML, Boryk R, Bisley JW, Dutson EP, Grundfest WS (2008) A haptic feedback system for lower-limb prostheses. IEEE Trans Neural Syst Rehabil Eng 16:270–277PubMedCrossRef

20.

Wottawa C, Fan RE, Lewis CE, Jordan B, Culjat MO, Grundfest WS, Dutson EP (2009) Laparoscopic grasper with an integrated tactile feedback system. In: Proceedings of 2009 ICME/IEEE international conference on complex medical engineering, Tempe, pp 1–5

21.

Shinohara M, Shimizu Y, Mochizuki A (1998) Three-dimensional tactile display for the blind. IEEE Trans Neural Syst Rehabil Eng 6:249–256CrossRef

22.

Kaczmarek KA, Webster JG, Bach-y-Rita P, Tompkins WJ (1991) Electrotactile and vibrotactile displays for sensory substitution systems. IEEE Trans Biomed Eng 38:1–16PubMedCrossRef

23.

Summers IR, Chanter CM (2002) A broadband tactile array on the fingertip. J Acoust Soc Am 112:2118–2126PubMedCrossRef

24.

Haga Y, Mizushima M, Matsunaga T, Esashi M (2005) Medical and welfare applications of shape memory alloy microcoil actuators. Smart Mater Struct 14:S266–S272CrossRef

25.

Howe RD, Kontarinis DA, Peine WJ (1995) Shape memory alloy actuator controller design for tactile displays. In: Proceedings of the 34th IEEE conference on decision and control, vol 4, New Orleans, pp 3540–3544

26.

Taylor PM, Hosseini-Sianaki A, Varley CJ (1996) An electrorheological fluid-based tactile array for virtual environments. In: IEEE international conference on robotics and automation, vol 1, pp 18–23

27.

Bicchi A, Scilingo EP, Sgambelluri N, De Rossi D (2002) Haptic interfaces based on magneto-rheological fluids. In: Proceedings of eurohaptics, Edingburgh, UK, pp 6–11

28.

Cohn MB, Lam M, Fearing RS (1992) Tactile feedback for teleoperation. In: Proceedings of the SPIE Telemanipulator Technology 1833, Boston, pp 240–255

29.

Asamura N, Yokoyama N, Shinoda H (1998) Selectively stimulating skin receptors for tactile display. IEEE Comput Graph Appl 18:32–37CrossRef

30.

Sato K, Igarashi E, Kimura M (1991) Development of nonconstrained master arm with tactile feedback device. In: ICAR, fifth international conference on advanced robotics: robots in unstructured environments, Pisa, pp 334–338

31.

Moy G, Wagner C, Fearing RS (2000) A compliant tactile display for teletaction. In: ICRA 2000 IEEE international conference on robotic automation, Piscataway, pp 3409–3415

32.

Rogers CH (1970) Choice of stimulator frequency for tactile arrays. IEEE Trans Man Mach Syst 11:5–11CrossRef

33.

Phillips JR, Johnson KO (1985) Neural mechanisms of scanned and stationary touch. J Acoust Soc Am 77:220–224PubMedCrossRef

34.

King CH, Culjat MO, Franco ML, Bisley JW, Dutson E, Grundfest WS (2008) Optimization of pneumatic balloon tactile display for robotic surgery based on human perception. IEEE Trans Biomed Eng 55:2593–2600PubMedCrossRef

35.

King CH, Franco ML, Culjat MO, Higa AT, Bisley JW, Dutson E, Grundfest WS (2008) Fabrication and characterization of a balloon actuator array for haptic feedback in robotic surgery. ASME J Med Devices 2:041006-1–041006-7CrossRef

36.

Wottawa C, Fan RE, Bisley JW, Duston EP, Culjat MO, Grundfest WS (2011) Applications of tactile feedback in medicine. Stud Health Technol Inform 163:703–709PubMed

37.

Culjat MO, King CH, Franco ML, Lewis CE, Bisley JW, Dutson EP, Grundfest WS (2008) A tactile feedback system for robotic surgery. Proc IEEE Eng Med Biol Soc 1:1930–1934

38.

Matern U, Waller P (1999) Instruments for minimally invasive surgery: principles of ergonomic handles. Surg Endosc 13:174–182PubMedCrossRef

Title: The role of tactile feedback in grip force during laparoscopic training tasks
Authors: Christopher R. Wottawa
Jeremiah R. Cohen
Richard E. Fan
James W. Bisley
Martin O. Culjat
Warren S. Grundfest
Erik P. Dutson
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 4/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2612-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of tactile feedback in grip force during laparoscopic training tasks

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2013

One surgeon’s learning curve for video-assisted thoracoscopic esophagectomy for esophageal cancer with the patient in lateral position: how many cases are needed to reach competence?

Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones

Prevalence of preoperative alcohol abuse among patients seeking weight-loss surgery

Single-incision laparoscopic surgery in children: a randomized control trial of acute appendicitis

Minimally invasive surgery adoption into an established surgical practice: impact of a fellowship-trained colleague

A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy