Force feedback requirements for efficient laparoscopic grasp control

Abstract

During laparoscopic grasping, tissue damage may occur due to use of excessive grasp forces and tissue slippage, whereas in barehanded grasping, humans control their grasp to prevent slippage and use of excessive force (safe grasp). This study investigates the differences in grasp control during barehanded and laparoscopic lifts. Ten novices performed lifts in order to compare pinch forces under four conditions: barehanded; using tweezers; a low-efficient grasper; and a high-efficient grasper. Results showed that participants increased their pinch force significantly later during a barehanded lift (at a pull-force level of 2.63 N) than when lifting laparoscopically (from pull-force levels of 0.77 to 1.08 N). In barehanded lifts all participants could accomplish a safe grasp, whereas in laparoscopic lifts excessive force (up to 7.9 N) and slippage (up to 38% of the trials) occurred frequently. For novices, it can be concluded that force feedback (additional to the hand-tool interface), as in skin-tissue contact, is a prerequisite to maintain a safe grasp. Much is known about grasp control during barehanded object manipulation, especially the control of pinch forces to changing loading, whereas little is known about force perception and grasp control during tool usage. This knowledge is a prerequisite for the ergonomic design of tools that are used to manipulate objects.

Design of Class Components for Laparoscopy Surgery Simulation with Haptic Elements: A Case Study of SPLasH

“…These has been done to overcome tissue trauma that caused by excessive grasp forces [28], [29]. This study is carried out to provide a learning aid that not focuses on series of tasks but a complete procedure that involve basic skill in laparoscopy surgery.…”

“…The level of grasp towards the body tissue must be within the safe area as shown in Figure 1. The boundaries of the safe area are formed by the damage line and the slip line [28]. The damage line is the boundary above where the tissue can be damaged due to certain combination of pinches or pulls force.…”

“…Even though many research has been carried out recently on laparoscopy surgery skill training [4], [5], [8], technologies and modeling of tissues [25]- [27] and also development made for laparoscopy skill training [12], [14]- [16], [18], [21], [24], [28]- [30] but most of the application developed or experiment carried out focuses on task but none of it provide for a single and complete surgery procedure such as hernia repair, cyst remove and etc. Research in grasp control shown that surgeons perform better if suitable application that provide force feedback thus help them in improve their skill ability [28]- [30]. This is the main reason why this research focuses on this vital skill.…”

Lack of transfer of skills after virtual reality simulator training with haptic feedback

“…challenges related to touch and proprioception, i.e. haptic feedback [12][13][14][15]. If the simulator reproduces technical aspects that are relevant for a surgical setting, and the trainee is exposed to them when training on the simulator, one might expect that skills acquired and objectively assessed on the simulator can be transferred to, and measured, in a clinical setting.…”

Evaluation of a Precise and Measurable Model for Learning Laparoscopic Tissue Handling

“…3,7,19Y22 Many box-trainer exercises rely on manufactured widgets designed for durability and therefore can withstand greater applied force than most biologic tissue without deformation or damage. 2,7,8 We designed low-cost, simulation-based laparoscopic training exercises that necessitate awareness of tissue handling to address this training gap. A simulation-based training system that does not support these important factors will only partially capture the applied surgical performance context, which could potentially lead to negative transfer if trainees master inappropriate technique through faulty perceptual feedback.…”