The Role of Haptic Feedback in Laparoscopic Simulation Training

被引:153
作者
Panait, Lucian [2 ]
Akkary, Ehab
Bell, Robert L.
Roberts, Kurt E.
Dudrick, Stanley J. [2 ]
Duffy, Andrew J. [1 ]
机构
[1] Yale Univ, Sch Med, Sect Gastrointestinal Surg, New Haven, CT 06510 USA
[2] St Marys Hosp, Waterbury, CT USA
关键词
virtual reality; surgical simulation; force feedback; haptic; VIRTUAL-REALITY SIMULATION; SURGERY;
D O I
10.1016/j.jss.2009.04.018
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction. Laparoscopic virtual reality simulators are becoming a ubiquitous tool in resident training and assessment. These devices provide the operator with various levels of realism, including haptic (or force) feedback. However, this feature adds significantly to the cost of the devices, and limited data exist assessing the value of haptics in skill acquisition and development. Utilizing the Laparoscopy VR (Immersion Medical, Gaithersburg, MD), we hypothesized that the incorporation of force feedback in the simulated operative environment would allow superior trainee performance compared with performance of the same basic skills tasks in a non-haptic model. Methods. Ten medical students with minimal laparoscopic experience and similar baseline skill levels as proven by performance of two fundamentals of laparoscopic surgery (FLS) tasks (peg transfer and cutting drills) voluntarily participated in the study. Each performed two tasks, analogous to the FLS drills, on the Laparoscopy VR at 3 levels of difficulty, based on the established settings of the manufacturer. After achieving familiarity with the device and tasks, the students completed the drills both with and without force feedback. Data on completion time, instrument path length, right and left hand errors, and grasping tension were analyzed. The scores in the haptic-enhanced simulation environment were compared with the scores in the non-haptic model and analyzed utilizing Student's t-test. Results. The peg transfer drill showed no difference in performance between the haptic and non-haptic simulations for all metrics at all three levels of difficulty. For the more complex cutting exercise, the time to complete the tasks was significantly shorter when force feedback was provided, at all levels of difficulty (158 +/- 56 versus 187 +/- 51 s, 176 +/- 49 versus 222 +/- 68 s, and 275 +/- 76 versus 422 +/- 220 s, at levels 1, 2, and 3, respectively, P < 0.05). Data on instrument path length, grasping tension, and errors showed a trend toward a benefit from haptics at all difficulty levels, but this difference did not achieve statistical significance. Conclusions. In the more advanced tasks, haptics allowed superior precision, resulting in faster completion of tasks and a trend toward fewer technical errors. In the more basic tasks, haptic-enhanced simulation did not demonstrate an appreciable performance improvement among our trainees. These data suggest that the additional expense of haptic-enhanced laparoscopic simulators may be justified for advanced skill development in surgical trainees as simulator technology continues to improve. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:312 / 316
页数:5
相关论文
共 11 条
[1]   Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery [J].
Aggarwal, Rajesh ;
Ward, Jonnie ;
Balasundaram, Indran ;
Sains, Parvinderpal ;
Athanasiou, Thanos ;
Darzi, Ara .
ANNALS OF SURGERY, 2007, 246 (05) :771-779
[2]  
American College of Surgeons, AM COLL SURG PROGR A
[3]   The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation [J].
Botden, Sanne M. B. I. ;
Torab, Fawaz ;
Buzink, Sonja N. ;
Jakimowicz, Jack J. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2008, 22 (05) :1214-1222
[4]   Augmented versus virtual reality laparoscopic simulation: What is the difference? A comparison of the ProMIS augmented reality laparoscopic simulator versus LapSim virtual reality laparoscopic simulator [J].
Botden, Sanne M. B. I. ;
Buzink, Sonja N. ;
Schijven, Marlies P. ;
Jakimowicz, Jack J. .
WORLD JOURNAL OF SURGERY, 2007, 31 (04) :764-772
[5]  
Kim Hyun K, 2004, Comput Aided Surg, V9, P227
[6]  
PANAIT L, 2008, P 89 ANN M NEW ENGL
[7]   What can the operator actually feel when performing a laparoscopy? [J].
Picod, G ;
Jambon, AC ;
Vinatier, D ;
Dubois, P .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2005, 19 (01) :95-100
[8]   The changing face of surgical education: Simulation as the new paradigm [J].
Scott, Daniel J. ;
Cendan, Juan C. ;
Pugh, Carla M. ;
Minter, Rebecca M. ;
Dunnington, Gary L. ;
Kozar, Rosemary A. .
JOURNAL OF SURGICAL RESEARCH, 2008, 147 (02) :189-193
[9]   Early exposure to haptic feedback enhances performance in surgical simulator training:: a prospective randomized crossover study in surgical residents [J].
Strom, P. ;
Hedman, L. ;
Sarna, L. ;
Kjellin, A. ;
Wredmark, T. ;
Fellander-Tsai, L. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2006, 20 (09) :1383-1388
[10]   A systematic review of skills transfer after surgical simulation training [J].
Sturm, Lana P. ;
Windsor, John A. ;
Cosman, Peter H. ;
Cregan, Patrick ;
Hewett, Peter J. ;
Maddern, Guy J. .
ANNALS OF SURGERY, 2008, 248 (02) :166-179