A Heuristic Force Model for Haptic Simulation of Nasogastric Tube Insertion Using Fuzzy Logic

Nasogastric tube (NGT) placement is an essential clinical skill. The training is conventionally performed on rubber mannequins albeit practical limitations. Computer simulation with haptic feedback can potentially offer a more realistic and accessible training method. However, the complex interactions between the tube and the nasogastric passage make it difficult to model the haptic feedback during NGT placement. In this paper, a fuzzy-logic-based approach is proposed to directly transfer the experience of clinicians in NGT placement into the simulation system. Based on their perception of the varying tactile sensation and the conditions during NGT placement, the membership functions and fuzzy rules are defined to develop the force model. Forces created using the model are then combined with friction forces to drive the haptic device and render the insertion forces in real time. A prototype simulator is developed based on the proposed force model and the implementation details are presented. The usability of the prototype is also evaluated by clinical teachers. The proposed methodology has the potential for developing computerized NGT placement training methods for clinical education. It is also applicable for simulation systems involving complicated force interactions or computation-expensive models.