Prevalence of haptic feedback in robot-mediated surgery : a systematic review of literature

© 2017 Springer-Verlag. This is a post-peer-review, pre-copyedit version of an article published in Journal of Robotic Surgery. The final authenticated version is available online at: https://doi.org/10.1007/s11701-017-0763-4With the successful uptake and inclusion of robotic systems in minimally invasive surgery and with the increasing application of robotic surgery (RS) in numerous surgical specialities worldwide, there is now a need to develop and enhance the technology further. One such improvement is the implementation and amalgamation of haptic feedback technology into RS which will permit the operating surgeon on the console to receive haptic information on the type of tissue being operated on. The main advantage of using this is to allow the operating surgeon to feel and control the amount of force applied to different tissues during surgery thus minimising the risk of tissue damage due to both the direct and indirect effects of excessive tissue force or tension being applied during RS. We performed a two-rater systematic review to identify the latest developments and potential avenues of improving technology in the application and implementation of haptic feedback technology to the operating surgeon on the console during RS. This review provides a summary of technological enhancements in RS, considering different stages of work, from proof of concept to cadaver tissue testing, surgery in animals, and finally real implementation in surgical practice. We identify that at the time of this review, while there is a unanimous agreement regarding need for haptic and tactile feedback, there are no solutions or products available that address this need. There is a scope and need for new developments in haptic augmentation for robot-mediated surgery with the aim of improving patient care and robotic surgical technology further.Peer reviewe

Putting the feel in ’look and feel‘

Haptic devices are now commercially available and thus touch has become a potentially realistic solution to a variety of interaction design challenges. We report on an investigation of the use of touch as a way of reducing visual overload in the conventional desktop. In a two-phase study, we investigated the use of the PHANToM haptic device as a means of interacting with a conventional graphical user interface. The first experiment compared the effects of four different haptic augmentations on usability in a simple targeting task. The second experiment involved a more ecologically-oriented searching and scrolling task. Results indicated that the haptic effects did not improve users performance in terms of task completion time. However, the number of errors made was significantly reduced. Subjective workload measures showed that participants perceived many aspects of workload as significantly less with haptics. The results are described and the implications for the use of haptics in user interface design are discussed

Constructing sonified haptic line graphs for the blind student: first steps

Line graphs stand as an established information visualisation and analysis technique taught at various levels of difficulty according to standard Mathematics curricula. It has been argued that blind individuals cannot use line graphs as a visualisation and analytic tool because they currently primarily exist in the visual medium. The research described in this paper aims at making line graphs accessible to blind students through auditory and haptic media. We describe (1) our design space for representing line graphs, (2) the technology we use to develop our prototypes and (3) the insights from our preliminary work

An Overview of Wearable Haptic Technologies and Their Performance in Virtual Object Exploration.

We often interact with our environment through manual handling of objects and exploration of their properties. Object properties (OP), such as texture, stiffness, size, shape, temperature, weight, and orientation provide necessary information to successfully perform interactions. The human haptic perception system plays a key role in this. As virtual reality (VR) has been a growing field of interest with many applications, adding haptic feedback to virtual experiences is another step towards more realistic virtual interactions. However, integrating haptics in a realistic manner, requires complex technological solutions and actual user-testing in virtual environments (VEs) for verification. This review provides a comprehensive overview of recent wearable haptic devices (HDs) categorized by the OP exploration for which they have been verified in a VE. We found 13 studies which specifically addressed user-testing of wearable HDs in healthy subjects. We map and discuss the different technological solutions for different OP exploration which are useful for the design of future haptic object interactions in VR, and provide future recommendations

Tactile-STAR: A Novel Tactile STimulator And Recorder System for Evaluating and Improving Tactile Perception

Many neurological diseases impair the motor and somatosensory systems. While several different technologies are used in clinical practice to assess and improve motor functions, somatosensation is evaluated subjectively with qualitative clinical scales. Treatment of somatosensory deficits has received limited attention. To bridge the gap between the assessment and training of motor vs. somatosensory abilities, we designed, developed, and tested a novel, low-cost, two-component (bimanual) mechatronic system targeting tactile somatosensation: the Tactile-STAR—a tactile stimulator and recorder. The stimulator is an actuated pantograph structure driven by two servomotors, with an end-effector covered by a rubber material that can apply two different types of skin stimulation: brush and stretch. The stimulator has a modular design, and can be used to test the tactile perception in different parts of the body such as the hand, arm, leg, big toe, etc. The recorder is a passive pantograph that can measure hand motion using two potentiometers. The recorder can serve multiple purposes: participants can move its handle to match the direction and amplitude of the tactile stimulator, or they can use it as a master manipulator to control the tactile stimulator as a slave. Our ultimate goal is to assess and affect tactile acuity and somatosensory deficits. To demonstrate the feasibility of our novel system, we tested the Tactile-STAR with 16 healthy individuals and with three stroke survivors using the skin-brush stimulation. We verified that the system enables the mapping of tactile perception on the hand in both populations. We also tested the extent to which 30 min of training in healthy individuals led to an improvement of tactile perception. The results provide a first demonstration of the ability of this new system to characterize tactile perception in healthy individuals, as well as a quantification of the magnitude and pattern of tactile impairment in a small cohort of stroke survivors. The finding that short-term training with Tactile-STARcan improve the acuity of tactile perception in healthy individuals suggests that Tactile-STAR may have utility as a therapeutic intervention for somatosensory deficits

W-FYD: a Wearable Fabric-based Display for Haptic Multi-Cue Delivery and Tactile Augmented Reality

Despite the importance of softness, there is no evidence of wearable haptic systems able to deliver controllable softness cues. Here, we present the Wearable Fabric Yielding Display (W-FYD), a fabric-based display for multi-cue delivery that can be worn on user's finger and enables, for the first time, both active and passive softness exploration. It can also induce a sliding effect under the finger-pad. A given stiffness profile can be obtained by modulating the stretching state of the fabric through two motors. Furthermore, a lifting mechanism allows to put the fabric in contact with the user's finger-pad, to enable passive softness rendering. In this paper, we describe the architecture of W-FYD, and a thorough characterization of its stiffness workspace, frequency response and softness rendering capabilities. We also computed device Just Noticeable Difference in both active and passive exploratory conditions, for linear and non-linear stiffness rendering as well as for sliding direction perception. The effect of device weight was also considered. Furthermore, performance of participants and their subjective quantitative evaluation in detecting sliding direction and softness discrimination tasks are reported. Finally, applications of W-FYD in tactile augmented reality for open palpation are discussed, opening interesting perspectives in many fields of human-machine interaction

Vibrotactile sensitivity in active touch: effect of pressing force

An experiment was conducted to study the effects of force produced by active touch on vibrotactile perceptual thresholds. The task consisted in pressing the fingertip against a flat rigid surface that provided either sinusoidal or broadband vibration. Three force levels were considered, ranging from light touch to hard press. Finger contact areas were measured during the experiment, showing positive correlation with the respective applied forces. Significant effects on thresholds were found for vibration type and force level. Moreover, possibly due to the concurrent effect of large (unconstrained) finger contact areas, active pressing forces, and long duration stimuli, the measured perceptual thresholds are considerably lower than what previously reported in the literature

Cutaneous Force Feedback as a Sensory Subtraction Technique in Haptics

A novel sensory substitution technique is presented. Kinesthetic and cutaneous force feedback are substituted by cutaneous feedback (CF) only, provided by two wearable devices able to apply forces to the index finger and the thumb, while holding a handle during a teleoperation task. The force pattern, fed back to the user while using the cutaneous devices, is similar, in terms of intensity and area of application, to the cutaneous force pattern applied to the finger pad while interacting with a haptic device providing both cutaneous and kinesthetic force feedback. The pattern generated using the cutaneous devices can be thought as a subtraction between the complete haptic feedback (HF) and the kinesthetic part of it. For this reason, we refer to this approach as sensory subtraction instead of sensory substitution. A needle insertion scenario is considered to validate the approach. The haptic device is connected to a virtual environment simulating a needle insertion task. Experiments show that the perception of inserting a needle using the cutaneous-only force feedback is nearly indistinguishable from the one felt by the user while using both cutaneous and kinesthetic feedback. As most of the sensory substitution approaches, the proposed sensory subtraction technique also has the advantage of not suffering from stability issues of teleoperation systems due, for instance, to communication delays. Moreover, experiments show that the sensory subtraction technique outperforms sensory substitution with more conventional visual feedback (VF)