Influence of force and torque feedback on operator performance in a VR-based suturing task

Abstract

The introduction of Minimally Invasive Surgery (MIS) has revolutionised surgical care, considerably improving the quality of many surgical procedures. Technological advances, particularly in robotic surgery systems, have reduced the complexity of such an approach, paving the way for even less invasive surgical trends. However, the fact that haptic feedback has been progressively lost through this transition is an issue that to date has not been solved. Whereas traditional open surgery provides full haptic feedback, the introduction of MIS has eliminated the possibility of direct palpation and tactile exploration. Nevertheless, these procedures still provide a certain amount of force feedback through the rigid laparoscopic tool. Many of the current telemanipulated robotic surgical systems in return do not provide full haptic feedback, which to a certain extent can be explained by the requirement of force sensors integrated into the tools of the slave robot and actuators in the surgeon's master console. In view of the increased complexity and cost, the benefit of haptic feedback is open to dispute. Nevertheless, studies have shown the importance of haptic feedback, especially when visual feedback is unreliable or absent. In order to explore the importance of haptic feedback for the surgeon's master console of a novel teleoperated robotic surgical system, we have identified a typical surgical task where performance could potentially be improved by haptic feedback, and investigate performance with and without this feedback. Two rounds of experiments are performed with 10 subjects, six of them with a medical background. Results show that feedback conditions, including force feedback, significantly improve task performance independently of the operator's suturing experience. There is, however, no further significant improvement when torque feedback is added. Consequently, it is deduced that force feedback in translations improves subject's dexterity, while torque feedback might not further benefit such a task.

Keywords:

• haptic IO
• force feedback
• torque feedback
• teleoperated surgery
• psycophysics
• suture accuracy

Acknowledgements

We thank Force Dimension for their technical support. We also thank the surgeons of the visceral surgery department of the Geneva University Hospital (HUG) and the surgeons of the Lausanne University Hospital (CHUV) who willingly participated in the experiment. This work is funded by the European Commission in the framework of the ARAKNES FP7 European Project EU/IST- 2008-224565. Prof. Roger Gassert is supported by the NCCR Neural Plasticity and Repair, Swiss Science National Foundation.