The Effect of Haptic Feedback on Efficiency and Safety During Preretinal Membrane Peeling Simulation

Abstract

Purpose We determine whether haptic feedback improves surgical performance and outcome during simulated a preretinal membrane peeling procedure. Methods A haptic-enabled virtual reality preretinal membrane peeling simulator was developed using a surgical cockpit with two multifinger haptic devices. Six subjects (three trained retina surgeons and three nonsurgeons) performed the preretinal membrane peeling surgical procedure using two modes of operation: visual and haptic feedback, and visual feedback only. Results Task completion time, tool tip path trajectory, tool–retina collision force, and retinal damage were all reduced with haptic feedback used and compared to modes where haptic feedback was disabled. Conclusions Haptic feedback improves efficiency and safety during preretinal membrane peeling simulation. Translational Relevance These findings highlight the potential benefit of haptic feedback for improving performance and safety of vitreoretinal surgery.

Advanced robotic surgical systems in ophthalmology

“…We have recently performed studies in the virtual environment (Fig. 8 ) to demonstrate that the addition of this feedback improves surgeon performance during pre-retinal membrane peeling procedures [ 23 ]. Participants over a range of skillsets were asked to perform virtual pre-retinal membrane peeling using two sets of feedback: (1) vision only and (2) vision with haptic feedback.…”

Virtual Reality Becomes a Reality for Ophthalmologic Surgical Clinical Trials

“…In ophthalmology, VR simulators have become highly sophisticated and compelling, using not only excellent three-dimensional visual recreations of the procedures that rival the best of VR video gaming today, but also haptic feedback that provides the user with procedure-specific realistic resistance. 11 , 12 The VRmagic Eyesi Surgical simulator (Mannheim, Germany), for example, is a unique VR simulator developed for intraocular surgery training that has been adopted for cataract surgery by most residency training programs in the United States. The introduction of Eyesi simulator training has been associated with reduced rates of complications in trainee-performed procedures, translating to improved outcomes in patients undergoing cataract surgery.…”

Reference tool kinematics-kinetics and tissue surface strain data during fundamental surgical acts

“…More recently, force-sensing bipolar forceps were used to measure forces during brain arteriovenous malformation surgery 8 and minimally invasive surgical tools were instrumented to provide force feedback in robotic-assisted surgery 9,10 . Haptic based surgical simulations have been developed for a variety of surgical procedures, including endoscopic surgery 11,12 , lumbar puncture 13 , epidural block delivery 14 , laproscopic suturing 15 , cerebral aneurysm clipping 16 and pre-retinal membrane peel 17 . While haptic feedback is provided during these simulations, there is a lack of quantifiable data used to validate the tissue-tool interaction used within the model.…”