The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review

BACKGROUND: Virtual reality (VR) as surgical training tool has become a state-of-the-art technique in training and teaching skills for minimally invasive surgery (MIS). Although intuitively appealing, the true benefits of haptic (VR training) platforms are unknown. Many questions about haptic feedback in the different areas of surgical skills (training) need to be answered before adding costly haptic feedback in VR simulation for MIS training. This study was designed to review the current status and value of haptic feedback in conventional and robot-assisted MIS and training by using virtual reality simulation. METHODS: A systematic review of the literature was undertaken using PubMed and MEDLINE. The following search terms were used: Haptic feedback OR Haptics OR Force feedback AND/OR Minimal Invasive Surgery AND/OR Minimal Access Surgery AND/OR Robotics AND/OR Robotic Surgery AND/OR Endoscopic Surgery AND/OR Virtual Reality AND/OR Simulation OR Surgical Training/Education. RESULTS: The results were assessed according to level of evidence as reflected by the Oxford Centre of Evidence-based Medicine Levels of Evidence. CONCLUSIONS: In the current literature, no firm consensus exists on the importance of haptic feedback in performing minimally invasive surgery. Although the majority of the results show positive assessment of the benefits of force feedback, results are ambivalent and not unanimous on the subject. Benefits are least disputed when related to surgery using robotics, because there is no haptic feedback in currently used robotics. The addition of haptics is believed to reduce surgical errors resulting from a lack of it, especially in knot tying. Little research has been performed in the area of robot-assisted endoscopic surgical training, but results seem promising. Concerning VR training, results indicate that haptic feedback is important during the early phase of psychomotor skill acquisitio

Patterns of traumatic injury in New York City prisoners requiring hospital admission

Bellevue Hospital\u27s prison ward cares for male prisoners requiring medical attention that exceeds the capabilities of New York City Department of Correction (NYC-DOC) infirmaries. This study evaluated the injury patterns that occur in this patient population. Data were collected on consecutive prisoners transferred from NYC-DOC for traumatic injuries from June 1, 2003, to June 1, 2006, and analyzed by retrospective chart review. Overall, 251 patients were evaluated for traumatic injuries. Injury mechanisms were violent (75.7%), nonviolent (23.5%), and self-inflicted (0.8%). Of the 241 (96%) patients admitted, 213 (84.9%) required operative intervention. The most common injuries were mandible fractures (46.5%) and facial fractures (14.9%)

The Effect of Vision on Discrimination of Compliance Using a Tool

This article describes a psychophysical experiment that investigates the effect of the source of vision on the perception of compliance with a specific focus on palpation, a basic surgical task. Twelve participants were asked to complete 4 forced-choice compliance discrimination tasks representing different modes of surgery when assessing soft human tissue. These tasks were compliance discrimination using direct vision, indirect vision on a computer monitor, only haptic information, and only indirect visual information. In the first 3 tasks, the subjects actively indented pairs of silicone stimuli covering a range of compliances simulating soft human tissue using a tool and were asked to choose which stimulus within each pair felt harder. In the 4th task, participants watched video recordings of the stimuli being indented on a monitor without touching the stimuli themselves. As a control task, participants performed discriminations using their index finger without any visual cues present. The results were used to determine psychometric functions of group behavior for all conditions. These functions suggest that participants performed best during the control task followed by that involving a combination of touch using tool and direct vision. The latter task presented higher compliance discriminability than the 3 remaining tasks. Moreover, the task using only indirect vision without any haptic information presented similar compliance discriminability to that using only touch through a tool without any visual information. It is concluded that although compliance discrimination via a tool is achievable under direct visual conditions, it remains significantly more challenging than through direct cutaneous information. The research shows the importance of visual cues for the discrimination of compliance as well as cross-modal integration of visual and haptic sensory information in compliance discrimination, with key implications for the development of new surgical tools and training systems