Force measurement platform for training and assessment of laparoscopic skills

Abstract

BackgroundTo improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual-reality (VR) trainers. Current training is mainly focused on hand–eye coordination. Training methods that focus on applying the right amount of force are not yet available.MethodsThe aim of this project is to develop a system to measure forces and torques during laparoscopic training tasks as well as the development of force parameters that assess tissue manipulation tasks. The force and torque measurement range of the developed force platform are 0–4 N and 1 Nm (torque), respectively. To show the potential of the developed force platform, a pilot study was conducted in which five surgeons experienced in intracorporeal suturing and five novices performed a suture task in a box trainer.ResultsDuring the pilot study, the maximum and mean absolute nonzero force that the novice used were 4.7 N (SD 1.3 N) and 2.1 N (SD 0.6 N), respectively. With a maximum force of 2.6 N (SD 0.4 N) and mean nonzero force of 0.9 N (SD 0.3 N), the force exerted by the experts was significantly lower.ConclusionsThe designed platform is easy to build, affordable, and accurate and sensitive enough to reflect the most important differences in, e.g., maximal force, mean force, and standard deviation. Furthermore, the compact design makes it possible to use the force platform in most box trainers.

Design of vessel ligation simulator for deliberate practice

“…These results are in agreement with previous studies of force exertion in suturing and knot-tying in laparoscopic surgery [2,4]. This showed that even though all participants were made aware that knot-tying force was measured, novices still have a tendency to be rougher when cinching knots during vessel ligations.…”

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

“…Force-related metrics have been mostly validated for suturing tasks [49,50,56]. Additionally, Rosen et al demónstrate that experienced surgeons apply higher [56].…”

Virtual Reality Simulators for Objective Evaluation on Laparoscopic Surgery: Current Trends and Benefits.

“…Sensing was performed by a specially built system, the BlueDragon, a bulky device with built-in mechanical sensors. More recently, Horeman et al have approached tool/tissue forces detection by means of a pressure platform placed under the box trainer task (Horeman et al, 2010). However, movement sensing has been one of the most common approaches followed.…”

“…The first ones include all those related with movements of hands and tools performed during a task: total path length, economy of movements, speed, motion smoothness, etc. Force related metrics, such as tool-tissue interactions, have also been studied by Rosen et al (Rosen et al, 2002), and, more recently, by Horeman et al (Horeman et al, 2010). Quality metrics, on the other hand, relate to the task's definition and execution.…”