Evaluating tactile feedback in robotic surgery for potential clinical application using an animal model

Abstract

Introduction The aims of this study were to evaluate 1) grasping forces with the application of a tactile feedback system in vivo 2) the incidence of tissue damage incurred during robotic tissue manipulation. Robotic-assisted minimally invasive surgery has been shown to be beneficial in a variety of surgical specialties, particularly radical prostatectomy. This innovative surgical tool offers advantages over traditional laparoscopic techniques, such as improved wrist-like maneuverability, stereoscopic video displays, and scaling of surgical gestures to increase precision. A widely cited disadvantage associated with robotic systems is the absence of tactile feedback. Methods and Procedure Nineteen subjects were categorized into two groups: 5 experts (six or more robotic cases) and 14 novices (five cases or less). The subjects used the da Vinci with integrated tactile feedback to run porcine bowel in the following conditions: (T1: deactivated tactile feedback; T2: activated tactile feedback; and T3: deactivated tactile feedback). The grasping force, incidence of tissue damage, and the correlation of grasping force and tissue damage were analyzed. Tissue damage was evaluated both grossly and histologically by a pathologist blinded to the sample. Results Tactile feedback resulted in significantly decreased grasping forces for both experts and novices (P < 0.001 in both conditions). The overall incidence of tissue damage was significantly decreased in all subjects (P < 0.001). A statistically significant correlation was found between grasping forces and incidence of tissue damage (P = 0.008). The decreased forces and tissue damage were retained through the third trial when the system was deactivated (P > 0.05 in all subjects). Conclusions The in vivo application of integrated tactile feedback in the robotic system demonstrates significantly reduced grasping forces, resulting in significantly less tissue damage. This tactile feedback system may improve surgical outcomes and broaden the use of robotic-assisted minimally invasive surgery.

Instrumental tactile diagnostics in robot-assisted surgery

“…To the best of our knowledge, despite a number of reports on perspective technologies,9–12,19,26 MTEC is currently the only commercially available medical device for intraoperative registration of tactile images. A previous study showed that for a simple testing stand, MTEC allowed correct localization of 95% of small heterogeneities (95% confidence interval for the correct detection rate: [0.83, 0.99]) 22.…”

“…Recent studies in this field showed that kinesthetic feedback provides a decrease of grasping force, which leads to lower tissue damage 19. However, design and implementation of diagnostic tactile feedback is still an open problem.…”

Haptics in Robot-Assisted Surgery: Challenges and Benefits

“…Experiments comprised three blocks of peg transfer tasks performed by 20 subjects (4 surgeons), demonstrated a significant reduction of grip force during robotic manipulation with presence of tactile feedback in comparison with no-tactilefeedback interactions. In-vivo experimentation by 19 surgeons on porcine models for potential clinical implementation of tactile-feedback-equipped da Vinci robot was reported in [110]. The experiments demonstrated that tactile feedback significantly decreased grasping forces for both expert and novice surgeons.…”

Pneumatically driven surgical forceps displaying a magnified grasping torque

“…The gripping torque τ s and the cylinder driving force f are obtained using the principle of virtual work, as follows: where J s is the Jacobian of the gripping mechanism. According to the other researches, the required force for the grasping organ is about 3 N . Therefore, we set the maximum torque of the forceps to 80 mNm that is calculated by multiplying 3 N and the gripper length of 27 mm.…”