Role of Haptic Feedback and Cognitive Load in Surgical Skill Acquisition (original) (raw)
Related papers
Effect of haptic feedback in laparoscopic surgery skill acquisition
Surgical Endoscopy, 2011
Background-The benefits of haptic feedback in laparoscopic surgery training simulators is a topic of debate in the literature. It is hypothesized that novice surgeons may not benefit from the haptic information, especially during the initial phase of learning a new task. Therefore, providing haptic feedback to novice trainees in the early stage of training may be distracting and detrimental to learning. Objective-A controlled experiment was conducted to examine the effect of haptic feedback on the learning curve of a complex laparoscopic suturing and knot-tying task. Method-The ProMIS and the MIST-VR surgical simulators were used to represent conditions with and without haptic feedback, respectively. Twenty novice subjects (10 per simulator) were trained to perform suturing and knot-tying and practiced the tasks over eighteen one-hour sessions. Results-At the end of the 3-week training period, subjects performed equally fast but more consistently with haptics (ProMIS) than without (MIST-VR). Subjects showed slightly higher learning rate and reached the first plateau of the learning curve earlier with haptic feedback. Conclusion-In general, learning with haptic feedback was significantly better than without haptic feedback for a laparoscopic suturing and knot-tying task, but only in the first 5 hours of training. Application-Haptic feedback may not be warranted in laparoscopic surgical trainers. The benefits of a shorter time to the first performance plateau and more consistent initial performance should be balanced with the cost of implementing haptic feedback in surgical simulators.
Mini-invasive Surgery , 2018
Aim: The mental demands of laparoscopic surgery create a steep learning curve for surgical trainees. Experienced surgeons informally conduct mental training prior to starting a complex laparoscopic procedure. Reconstructing haptic feedback to mentally observe surgeon-instrument-tissue interaction is considered to be acquired only with experience. An experiment was devised to implement mental training for the haptic feedback reconstruction and its effect on laparoscopic task performance was observed. Methods: Twenty laparoscopy novice medical students with normal/corrected visual acuity and normal hearing were randomised into two groups. Both groups were asked to apply a pre-established consistent force by means of retracting a laparoscopic grasper fixed to an electronic weight scale. Studied group underwent mental training while control group conducted a laparoscopic task as a distraction exercise. Accuracy of the task performance was measured as primary outcome. Performance between dominant and non-dominant hands was the secondary outcome. Results: Baseline assessment of both dominant and non-dominant hands between groups were similar (P > 0.05). Mental training group improved their performance (0.66 ± 0.04) vs. (1.06 ± 0.14) with dominant hand (P < 0.01) and (0.73 ± 0.04) vs. (1.10 ± 0.20) with non-dominant hand (P < 0.05), when compared with control group. Conclusion: In a laparoscopic task performance, skill transfer is significantly accurate if mental haptic feedback reconstruction is achieved through mental training.
Learning Through Haptics: Haptic Feedback in Surgical Education
2016
for their insightful comments and encouragement which incented me to widen my research from various perspectives. Last but not the least, I would like to thank my family: my wife and to my parents for supporting me throughout developing this research.
Periodic Kinesthetic Guidance Cannot Expedite Learning Surgical Skills
Surgical Innovation, 2020
Introduction. Connecting multiple haptic devices in a master-slave fashion enables us to deliver kinesthetic (haptic) feedback from 1 person to another. This study examined whether inter-user feedback delivered from an expert to a novice would facilitate skill acquisition of the novice in learning laparoscopic surgery and expedite it compared to traditional methods. Methods. We recruited fourteen novices and divided them into 1 of 2 training groups with 6 halfhour training sessions. The task was precision cutting adopted from one of the tasks listed in Fundamentals of Laparoscopic Surgery using laparoscopic instruments. In the haptic feedback group (haptic), 8 subjects had the chance to passively feel an expert's performance before they started to practice in each training session. In the self-learning group (control), 6 subjects watched a video before practicing. Each session was video recorded, and task performance was measured by task completion time, number of grasper adjustments, and instrument crossings. Cutting accuracy, defined as the percentage of deviation of the cutting line from the predefined line, was analyzed via computer analysis. Results. Results show no significant difference among performance measures between the 2 groups. Participants performed similarly when practicing alone or with periodic haptic feedback. Discussion. Further research will be needed for improving our way of integrating between-person haptic feedback with skills training protocol.
Visual clues act as a substitute for haptic feedback in robotic surgery
Surgical Endoscopy, 2008
Objective The lack of haptic feedback (HF) in robotic surgery is one of the major concerns of novice surgeons to that field. The superior visual appearances acquired during robotic surgery may give clues that make HF less important. Methods We surveyed 52 individuals on their perception of HF during robotic surgery. The first group of 34 surgically inexperienced people used the da Vinci robot for their first time (drylab). The second group included 8 laparoscopic surgeons with experience up to a fifth robotic operation. The third group included 10 surgical experts with substantial experience (150-650 robotic cases). Visual analog assessment was made of perception of HF, how much HF was missed, how much the absence of HF impaired the operators' level of comfort. Robotic experts were asked if complications have occurred as a result of a lack of HF. Results Of the first group, 50% reported the perception of HF, as did 55% of the second group and 100% of the third group (difference between group 1 and group 3: p \ 0.05). The first group missed HF for 6.5; the second group for 4.3, and the third group for 4 (difference between groups 1 and 3: p \ 0.05). The surgical experts claimed to have missed HF for 7.2 s when they first started robotic surgery (Difference to now: p \ 0.05). The lack of HF caused discomfort for the first group of 4; for the second group of 4,4, and for the third group of 2,6. One complication was
Surgeon Training with Haptic Devices for Computer and Robot Assisted Surgery: An Experimental Study
XV Mediterranean Conference on Medical and Biological Engineering and Computing – MEDICON 2019, 2019
Development of robot-assisted minimally invasive surgery increasingly demands for efficient training methods. This paper describes an experiment exploring the use of haptic interaction for the purpose of skill training (haptic training). Various experiment tasks that include simple and complex tool paths have been developed for this purpose. 105 acquisition sessions distributed in 7 different tasks from 27 naive subjects and one surgeon performed teleoperated exercises with Omni Phantom. Task's learning curves with and without robotic assistance and effects of damping have been discussed. For the force guidance case, assistance level gradually decreased the applied force as the training progressed. In the controversial scenario of robotic assistance for motorlearning benefits, this study shows such assistance improve the rate of learning for both simple and complex tasks.
Surgical Endoscopy, 2009
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 Evidencebased 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 acquisition.