Haptic based fundamentals of laparoscopic surgery simulation for training with objective assessments

Area of Science:

• Medical Simulation
• Surgical Training
• Haptics Technology

Background:

• Fundamental Laparoscopic Surgery (FLS) is a standard training program but lacks objective force measurement.
• Current laparoscopic virtual reality (VR) simulators often lack force feedback or rely on subjective metrics.
• Objective force assessment is crucial for effective haptic skills training in VR environments.

Purpose of the Study:

• To develop and validate a haptic-based Fundamental Laparoscopic Surgery (HFLS) system for objective force assessment in VR surgical training.
• To evaluate the face and content validity of the HFLS system among laparoscopic surgeons.
• To investigate the effectiveness of a laparoscopic tool force model for enhancing force rendering accuracy.

Main Methods:

• Extended FLS part tasks to a haptic-based system with a 5-DOF bi-manual haptic simulator.
• Conducted face and content validity assessments with surgeons of varying experience levels.
• Incorporated a laparoscopic tool force model and conducted a psychophysical study to measure just noticeable difference (JND) in gripping force.

Main Results:

• Trainees performed better in HFLS tasks, with high average Likert scores for face (4.6 ± 0.3) and content (4 ± 0.5) validity.
• The study indicated a need to improve haptic realism in the simulator.
• A simple linear model was sufficient for gripper force feedback within the 0.5-2.5 N range, with no significant impact from a non-linear LapTool model.

Conclusions:

• The developed HFLS system demonstrates acceptance and potential for objective force assessment in laparoscopic VR training.
• Improvements in haptic realism are needed for existing and proposed simulators.
• Further research is required to explore the force model's usability at higher force ranges and confirm construct validity.