In minimally invasive surgery (MIS), it is critical to have the ability to accurately interpret haptic information and apply appropriate force magnitudes onto soft tissue in order to minimize tissue trauma. The surgeon's administration of force onto tissue reveals useful perceptual information which guides further haptic interaction making the force perception in MIS a dynamic process. It has been hypothesized that the compliant nature of soft tissue during force application provides biomechanical information denoting tissue failure. Specifically, the relationship between applied force and material deformation rate specifies the distance remaining until the tissue will fail, which is termed distance-to-break (DTB). Two experiments explored sensitivity to DTB; one with an exploratory task and the other using a unidirectional task. Findings revealed that observers could reliably perceive DTB in simulated biological tissues in the exploratory task but they were unable to perform the unidirectional task. It was also found that the perception of DTB can be improved through feedback training. Implications for optimizing training in MIS simulators are discussed.

Accurate detection of mediated haptic information in minimally invasive surgery (MIS) is critical for applying appropriate force magnitudes onto soft tissue with the aim of minimising tissue trauma. Force perception in MIS is a dynamic process, with surgeons' administration of force into tissue revealing information about the remote surgical site which further informs the surgeons' haptic interactions. The relationship between applied force and material deformation rate provides biomechanical information specifying the deformation distance remaining until a tissue will fail: which is termed distance-to-break (DTB). The current study demonstrates that observers can detect DTB while deforming simulated tissues and stop before reaching the tissues' failure points. The design of training simulators, control devices and automated robotic systems for applications outside of MIS is discussed. Practitioner Summary: In MIS, haptic information is critical for applying appropriate forces onto soft tissue to minimise tissue trauma. Observers used force information to detect how far they could deform a virtual tissue before it would break. The design of training simulators, control devices and automated robotic systems is discussed.

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Two experiments employed attunement and calibration training to investigate whether observers are able to identify material break points in compliant materials through haptic force application. The task required participants to attune to a recently identified haptic invariant, distance-to-break (DTB), rather than haptic stimulation not related to the invariant, including friction. In the first experiment participants probed simulated force-displacement relationships (materials) under 3 levels of friction with the aim of pushing as far as possible into the materials without breaking them. In a second experiment a different set of participants pulled on the materials. Results revealed that participants are sensitive to DTB for both pushing and pulling, even in the presence of varying levels of friction, and this sensitivity can be improved through training. The results suggest that the simultaneous presence of friction may assist participants in perceiving DTB. Potential applications include the development of haptic training programs for minimally invasive (laparoscopic) surgery to reduce accidental tissue damage. (PsycINFO Database Record

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