Tactile Sensors for Minimally Invasive Surgery: A Review of the State-of-the-Art, Applications, and Perspectives

Abstract

Minimally invasive surgery has been one of the most significant evolutions in medicine. In this approach, the surgeon inserts specially-designed instruments through a small incision on the patient's skin into the body cavities, abdomen, veins or, arteries and performs the surgery on organs. As a major limitation, surgeons lose their natural tactile perception due to indirect touch on the organs. Since the loss of tactile perception compromises the ability of surgeons in tissue distinction and maneuvers, researchers have proposed different tactile sensors. This review is to provide researchers with a literature map for the state-of-the-art of tactile sensors in minimally invasive surgery, e.g. in robotic, laparoscopic, palpation, biopsy, heart ablation, and valvuloplasty. In this regard, the pertinent literature from the year 2000 on sensing principles, design requirements, and specifications were reviewed in this study. The survey showed that size, range, resolution, variation, electrical passivity, and magnetic-resonance-compatibility were the most critical specification to study for tactile sensors. Based on the results, some of the requirements, e.g., magnetic-resonance-compatibility and electrical passivity are of less generality and more applicationdependent; however, size, resolution, and range specifications differ for various applications and are of utmost importance.

Research and Development of Testing Device for Evaluating Force Transmission, Friction, and Contact Pressure Distribution of Surgical Spring Forceps (Tweezers)

“…At the same time, because of the rigorous environment in which surgical instruments are used and the simplicity of forceps construction, they are not used with the same variety of datasheet as electronic components and are operated purely by experience and feel. The same problem occurs in minimally invasive surgery, (2)(3)(4)(5) which has become increasingly sophisticated in the last decade and is hampered by the complete loss of tactile feedback in robot-assisted surgery. (6,7) The loss and blurring of haptic feedback in these two types of surgery have therefore attracted the attention of many researchers and development organizations, who have attempted to provide assistance to surgeons using a variety of components such as haptic sensors, (8)(9)(10)(11) optical sensors, (12,13) and posture sensors (14) in conjunction with real-time image assistance systems, augmented reality, virtual reality, and other technologies.…”

A Piezoelectric Tactile Sensor for Tissue Stiffness Detection with Arbitrary Contact Angle

“…Since the lumps are often harder than the surrounding normal tissues, doctors can usually directly distinguish the lump by the difference in stiffness felt. [ 1 , 2 ] In order to distinguish different stiffness in RMIS, a tactile sensor for tissue stiffness detection is essential.…”

Tactile Perception Technologies and Their Applications in Minimally Invasive Surgery: A Review

“…With the development of mechatronics, robot-assisted minimally invasive surgery (RMIS) systems, such as the ZEUS Surgical System ( Uranues et al, 2002 ) and the da Vinci Surgical System ( Guthar and Salisbury, 2000 ), have been developed to improve the dexterity of tools during manipulation, which partly resolve the motion constrain problem. Despite this, there are still limitations existing for MIS, including reduced hand-eye coordination, a narrowed field of vision, and limited workspace of the tools ( Bandari et al, 2020 ). More importantly, surgeons have little tactile information in MIS compared to the rich tactile feedback of human hands, which severely impairs the surgeon’s ability to control the applied forces, thus causing extra tissue trauma or unintentional damage to healthy tissue ( Ahmadi et al, 2012 ).…”

“…Among this tactile information, force data are relatively easy to acquire, model, quantify, and display, so it is most widely used in MIS. The sensing principles, design requirements, specifications, developments of force sensors, and their applications in MIS have been thoroughly reviewed ( Eltaib and Hewit, 2003 ; Puangmali et al, 2008 ; Schostek et al, 2009 ; Tiwana et al, 2012 ; Abushagur et al, 2014 ; Konstantinova et al, 2014 ; Saccomandi et al, 2014 ; Park et al, 2018 ; Al-Handarish et al, 2020 ; Bandari et al, 2020 ). In contrast, studies on utilizing other tactile information in MIS are very rare.…”