Tags:Haptic feedback, Robotic surgery and Skill assessment
Abstract:
Up to half of the technical errors made by surgical trainees result from improper tool forces on tissue. This skill inadequacy is exacerbated in robotic minimally invasive surgery (RMIS) due to the perpetual technical barriers prohibiting robust haptic (touch) sensations in clinical RMIS systems. RMIS experts have developed visual-haptic acuity - the ability to visually estimate absent haptic sensations - through years of surgical practice with real patient tissue. Current RMIS trainees face various technical and practical limitations inhibiting such skill development, so there is a critical need for improved visual-haptic acuity development. Previous research showed that haptic feedback provided during RMIS training helped trainees increase speed and accuracy, but these benefits have not been demonstrated beyond basic simulated training environments. Additionally, we lack objective methods for assessing trainees’ skill level when operating on real patient tissue. For this reason, we are developing a modular data acquisition and multimodality haptic feedback system to catalyze visual-haptic acuity development for RMIS trainees. We expand on prior work, which demonstrated the efficacy of this system using an Intuitive da Vinci Si clinical robot, to better understand how it may be used for objective assessment of visual-haptic acuity during RMIS training, and real-time haptic feedback based on these assessments. We recorded surgical interactions between sensorized da Vinci instruments and an ex vivo porcine bowel as an intermediate and expert surgeon completed a simulated bowel running and knot tying task. Results highlight the difference in various kinetic metrics between intermediate and expert performance. When coupled to our haptic feedback devices, these measures can be used to both assess and augment tissue handling skill during training, which we envision will catalyze visual-haptic acuity development.
Towards a Robotic Minimally Invasive Surgery Assessment and Augmentation Platform for Visual-Haptic Acuity Development