Impact of laparoscopic training, haptic feedback and visual haptic latency on virtual fine motor performance

Advancements in minimally invasive surgery, including haptic feedback and telesurgery systems, offer potential benefits for surgical education and patient outcomes. However, the impact of general visuomotor skills (GVS), laparoscopic experience, and system latency on performance remains unclear. This study aimed to investigate how these factors interact during fine motor task execution. Fifty-seven medical students participated, with one subgroup (n = 29) receiving proficiency-based laparoscopic training and another (n = 28) without training. GVS were measured using the Purdue Pegboard Test, and laparoscopic skills via the Peg Transfer task. Participants then performed a Virtual Reality Wire Loop Game (WLG) under varying feedback conditions: visual feedback (real-time [VF0] or 200 ms delay [VF200]) and haptic feedback (real-time [HF0], delayed [HF200], or absent [noHF]). Performance metrics included error times, task completion times, and subjective difficulty ratings. Trained participants demonstrated significantly fewer errors, shorter completion times, and reduced instrument path length on the Peg Transfer task (all p < 0.01), whereas no between-group differences emerged in Purdue Pegboard Test scores (all p > 0.05). A 200 ms visual delay significantly worsened WLG performance (p < 0.001) and increased perceived difficulty (p < 0.001). Real-time haptic feedback was rated more useful, particularly without visual delay, and its perceived benefit increased with LE (p < 0.001). Minimizing visual latency is essential in telesurgery. Real-time haptic feedback enhances performance, especially for experienced users.