Reviewing the technological challenges associated with the development of a laparoscopic palpation device

Culmer, Peter; Barrie, Jenifer; Hewson, Robert; Levesley, Martin; Mon-Williams, Mark; Jayne, David; Neville, Anne

doi:10.1002/rcs.1421

Cited by 25 publications

(20 citation statements)

References 85 publications

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“…While laparoscopy has proved to be an efficient and viable substitute for open surgery in many procedures, it still poses some concerns that need to be addressed. Laparoscopic surgeons must compensate for reduced kinaesthetic, and cutaneous tactile feedback by relying largely on visual information provided by a twodimensional (2D) monitor as well as limited haptic feedback transmitted through the laparoscopic tools (Culmer et al, 2012). Real world three-dimensional tissue structures are hence reduced to two-dimensional images and video projected on a screen (Kashihara, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Palpation is a very powerful surgical tool used by clinicians to detect irregularities and tumours (Langrana, Burdea, Ladeji, & Dinsmore, 1997). Surgeons assess tissue health, for example to locate potentially cancerous tumours (Bholat, Haluck, Kutz, Gorman, & Krummel, 1999), by palpating (pressing or tapping) the tissue surface using both haptic and visual information (Culmer et al, 2012). Abnormal tissue typically has distinct mechanical characteristics (such as compliance) from healthy tissue (Carter, Frank, Davies, McLean, & Cuschieri, 2001), thus allowing the surgeon to discriminate by evaluating these changes.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Vision on Discrimination of Compliance Using a Tool

Fakhoury

Culmer

Henson

2014

International Journal of Human-Computer Interaction

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This paper describes a psychophysical experiment which 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 four 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 fourth 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 behaviour 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 three 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. We conclude that while 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 a 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.--

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Vision on Discrimination of Compliance Using a Tool

Fakhoury

Culmer

Henson

2014

International Journal of Human-Computer Interaction

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“…For example, physicians and surgeons perceive the compliance of biological tissues to diagnose symptoms of diseases [4] or to distinguish between healthy tissue and malignant tumors [5]. However, in robotic or minimally invasive surgery, this tactile information is not communicated through the rigid handles of surgical instruments [6][7][8]. In these circumstances, surgeons rely mostly on visual information during the operation.…”

Section: Introductionmentioning

confidence: 99%

“…The provided visual information is usually limited [9] and more importantly cannot properly substitute for information regarding compliance, which is best perceived through the sense of touch [10]. For this reason, surgical instruments capable of sensing the mechanical properties of tissue and rendering missing tactile information to the surgeons are needed [6].…”

Section: Introductionmentioning

confidence: 99%

Compliance display using a tilting-plate tactile feedback device

Yazdian¹,

Doxon²,

Johnson³

et al. 2014

2014 IEEE Haptics Symposium (HAPTICS)

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This paper presents a tactile display device for replicating compliance sensation when interacting with deformable and nondeformable compliant objects in a virtual environment. Two small tilting plates approximately reproduce surface deformations of a compliant object. In addition to tactile information, kinesthetic information is rendered through a modified haptic paddle force feedback device. The tilting plates are moved in conjunction with the measured position of the user's finger as they pressed into the virtual surface. In a psychophysical experiment, we evaluated the effect of adding tilting motion of the device's actuated plates on the perceived compliance of a virtual surface with a kinesthetic stiffness of 60 N/mm. The experiment results indicate that tilting rates of 5, 10, and 20 deg/cm reduced the perceived stiffness of the surface by 3, 9, and 17 N/m, respectively. The advantages of the new device include its light-weight, low-cost, and simple design. These device features make it practical to integrate this compliance display with user interfaces for applications such as video games or even robotic surgery.

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“…In these palpations, the surgeons make the decision based on information given by the systems and the operation. Thus, the method by which the acquired information is fed back to a surgeon is an important design factor (Culmer et al, 2012).…”

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confidence: 99%

DNN-Based Assistant in Laparoscopic Computer-Aided Palpation

et al. 2018

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Tactile sensory input of surgeons is severely limited in minimally invasive surgery, therefore manual palpation cannot be performed for intraoperative tumor detection. Computer-aided palpation, in which tactile information is acquired by devices and relayed to the surgeon, is one solution for overcoming this limitation. An important design factor is the method by which the acquired information is fed back to the surgeon. However, currently there is no systematic method for achieving this aim, and it is possible that a badly implemented feedback mechanism could adversely affect the performance of the surgeon. In this study, we propose an assistance algorithm for intraoperative tumor detection in laparoscopic surgery. Our scenario is that the surgeon manipulates a sensor probe, makes a decision based on the feedback provided from the sensor, while simultaneously, the algorithm analyzes the time series of the sensor output. Thus, the algorithm assists the surgeon in making decisions by providing independent detection results. A deep neural network model with three hidden layers was used to analyze the sensor output. We propose methods to input the time series of the sensor output to the model for real-time analysis, and to determine the criterion for detection by the model. This study aims to validate the feasibility of the algorithm by using data acquired in our previous psychophysical experiment. There, novice participants were asked to detect a phantom of an early-stage gastric tumor through visual feedback from the tactile sensor. In addition to the analysis of the accuracy, signal detection theory was employed to assess the potential detection performance of the model. The detection performance was compared with that of human participants. We conducted two types of validation, and found that the detection performance of the model was not significantly different from that of the human participants if the data from a known user was included in the model construction. The result supports the feasibility of the proposed algorithm for detection assistance in computer-aided palpation.

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Reviewing the technological challenges associated with the development of a laparoscopic palpation device

Cited by 25 publications

References 85 publications

The Effect of Vision on Discrimination of Compliance Using a Tool

The Effect of Vision on Discrimination of Compliance Using a Tool

Compliance display using a tilting-plate tactile feedback device

DNN-Based Assistant in Laparoscopic Computer-Aided Palpation

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