Towards a robotic minimally invasive surgery assessment and augmentation platform for visual-haptic acuity development

Abstract

Up to half of the technical errors made by surgical trainees result from improper tool forces on tissue [1]. This skill inadequacy is exacerbated in robotic min- imally invasive surgery (RMIS) due to the perpetual technical barriers prohibiting robust haptic (touch) sen- sations in clinical RMIS systems. Expert RMIS surgeons have developed a unique skill, termed visual-haptic acuity, that enables them to visually estimate the absent haptic sensations [2]. RMIS experts have developed this visual-haptic acuity through years of repeated surgi- cal practice, on real patient tissue. For current RMIS trainees, limitations on working hours and caseloads severely constrain practice with real patient tissue [3]. Given that skill gained in virtual reality simulation does not always transfer to the real world [4], there is a critical need for a focus on visual-haptic acuity development. Previous research has shown that supplemental hap- tic feedback provided during simulation-based RMIS training helps surgical trainees to reduce their applied forces when completing RMIS training tasks [5], and that this effect is sustained even when haptic feedback is removed [6]. In addition, supplemental haptic feedback has demonstrated the potential to help RMIS trainees increase accuracy (reduce applied forces) while also increasing speed (reducing task completion time) during RMIS training [7]. Unfortunately, the benefits of sup- plemental haptic feedback have not been demonstrated beyond basic simulated training environments. Addition- ally, we lack validated objective methods for specifically assessing an RMIS trainee’s ability to visually estimate haptic sensations when operating on real patient tissue. In light of this need, we are developing a modular data acquisition and multimodality haptic feedback system (as shown in Figure 1) to catalyze visual-haptic acuity development for novice RMIS trainees.