Eric Cao1, Sergio Machaca1, Timothy Bernard2, Brett Wolfinger1, Zachary Patterson3, Amy Chi1, Gina Adrales, MD4, Katherine J Kuchenbecker, PhD5, Jeremy D Brown, PhD1. 1Johns Hopkins University, 2University of Maryland Baltimore County, 3Carnegie Mellon University, 4Johns Hopkins Medical Institute, 5Max Planck Institute for Intelligent Systems
INTRODUCTION: Most clinically approved robot-assisted surgical systems such as the Intuitive Surgical da Vinci provide no haptic feedback. Consequently, safely handling tissue with the robotic instruments can be challenging, especially for novice trainees. While most surgical training paradigms focus on maximizing speed and minimizing tissue interaction forces, task completion time is often the primary performance metric. We hypothesize that providing novices with tactile feedback of the force magnitude they apply while training will significantly reduce their root-mean-square (RMS) force magnitudes while increasing their completion time compared to trainees receiving no feedback.
METHODS: Novice participants with no prior da Vinci or clinical experience (n = 8) performed a ring rollercoaster training task twelve times using a da Vinci S surgical robot. Participants were instructed to finish each trial as quickly as possible, to use both hands, and to avoid dropping or damaging the ring. Wrist-squeezing tactile actuators delivered bimanual haptic feedback in proportion to the magnitude of the 3D force vector applied to the track. Participants in the feedback group (n = 4) received haptic feedback for all twelve trials, while participants in the no-feedback group (n = 4) completed all trials without haptic feedback. Trial duration and RMS force were calculated for all trials.
RESULTS: Participant in both groups significantly reduced their trial duration between the beginning (trials 1-3) and end (trials 10-12) of the experiment (p<0.01 for both groups). While participants in the feedback group were significantly slower than participants in the no-feedback group in the first three trials (p<0.01), this between-group difference was not significant by the last three trials of the experiment. Regarding the forces produced on the task materials, neither group significantly increased or decreased their RMS force between the beginning (trials 1-3) and end (trials 10-12) of the experiment. However, participants in the feedback group produced significantly less RMS force than participants in the no-feedback group overall for the 12 trials of the experiment (p<.001).
CONCLUSIONS: Providing novice da Vinci users with tactile feedback of the forces they exerted did not affect final task completion time and significantly reduced the applied forces. These results highlight the potential efficacy of this approach to helping early novices understand and reduce the forces applied via a robot-assisted surgical system, potentially reducing tissue damage and suture breakage in the clinical setting later on.
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Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94852
Program Number: P377
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster