Evaluation of tactile guidance cue mappings for emergency percutaneous needle insertion

Abstract

In severe trauma cases, rare but fatal conditions may quickly arise, requiring immediate percutaneous needle insertion to save the patient. As there is no time to wait for experts, inexperienced individuals are required to perform these procedures, often leading to complications. We propose the design of a novel vibrotacile sleeve to guide users through this task. While realization of a robust closed-loop guidance system is far from complete, we begin this project by identifying and evaluating three major guidance cue mappings that could be used for our sleeve: (1) tool space (guiding needle orientation and insertion), (2) Cartesian space (guiding desired needle tip), and (3) joint space (guiding user elbow and wrist angles). In this paper, we aim to determine which of these mappings have the best performance in a simulated needle insertion task. We developed an adjustable sleeve consisting of a stretchable fabric with vibrotactile motors, affixed using hook-and-loop material. In a human subject study, we evaluated the effectiveness of these cues to elicit a series of desired movements (up, down, lateral motion, rotation, diagonal movement) by tracking the subject movements as they interacted with a haptic device. We found that tool space guidance mappings lead to significantly lower normalized direction error for both up/down and diagonal movements (p value <0.0001). Users also rated tool space as the easiest mapping (1.87/5, SD= 0.75) and found that diagonal movements were the most difficult cues to understand.

Training System for White Cane Technique Using Illusory Pulling Cues Induced by Asymmetric Vibrations

“…In contrast, vibrotactile cues do not require the ground point for the external environment. The presentation of the vibrotactile cue to an end effector, such as the hand [29] or wrist [30] is more feasible than the presentation to a joint because the motion of the upper limb depends mainly on the position of a hand. However, the vibration stimuli have no directional cue, such as a force.…”

A review on the techniques used in prostate brachytherapy

“…Another option as previously stated is to give the haptic feedback to the surgeon. Basu et al [77] presented a robust closed-loop guidance system with haptic device. Based on their research, Rossa, Fong, et al [78] presented a design of a wristband with haptic feedback to assist surgeons to guide the steered needles.…”

Rethinking Autonomous Surgery: Focusing on Enhancement over Autonomy

“…Nonsystematic review Systematic review [38] Research [39][40][41][42][43] Randomized crossover trial [42] Crossover trial [39][40][41]43] Existing methods lack realism, methods to enhance fidelity not feasible for real-time human interaction owing to computational complexity Haptic movement guidance Research [44][45][46][47][48][49][50][51][52] Demonstration only [44] Crossover trial [45,50,51] Randomized concurrent controlled trial [46,52] Psychophysics (accuracy) [47,48] Randomized crossover trial [49] Paucity of guidelines on effective feedback strategies, variability across human learners…”

“…An alternative approach to reflective haptic feedback is guidance haptic feedback, in which the goal is not to simulate the patient's tissue properties but rather to enhance motor learning via haptic or tactile motion cues-cues that become critical in human-robot collaborative environments. Studies have shown the effectiveness of haptic feedback in developing motor skills [44][45][46] and guiding movement [47][48][49]. A common type of training of motor skills with haptic feedback involves recording an expert's movements and having a novice follow those movements, with haptic feedback provided if they deviate from the intended path [50].…”