Haptic exploration improves performance of a laparoscopic training task
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and Other Interventional Techniques
Haptic exploration improves performance of a laparoscopic training task Roelf R. Postema1,2 · Leonie A. van Gastel1 · Sem F. Hardon1,2 · H. Jaap Bonjer1 · Tim Horeman2 Received: 25 March 2020 / Accepted: 1 July 2020 © The Author(s) 2020
Abstract Background Laparoscopy has reduced tactile and visual feedback compared to open surgery. There is increasing evidence that visual and haptic information converge to form a more robust mental representation of an object. We investigated whether tactile exploration of an object prior to executing a laparoscopic action on it improves performance. Methods A prospective cohort study with 20 medical students randomized in two different groups was conducted. A silicone ileocecal model, on which a laparoscopic action had to be performed, was used inside an outside a ForceSense box trainer. During the pre-test, students either did a combined manual and visual exploration or only visual exploration of the caecum model. To track performance during the trials of the study we used force, motion and time parameters as representatives of technical skills development. The final trial data were used for statistical comparison between groups. Results All included time and motion parameters did not show any clear differences between groups. However, the force parameters Mean force non-zero (p = 004), Maximal force (p = 0.01) Maximal impulse (p = 0.02), Force volume (p = 0.02) and SD force (p = 0.01) showed significant lower values in favour of the tactile exploration group for the final trials. Conclusions By adding haptic sensation to the existing visual information during training of laparoscopic tasks on life-like models, tissue manipulation skills improve during training. Keyword Laparoscopy training · Box trainer · Tactile exploration · Haptics · ForceSense Both senior authors H. Jaap Bonjer and Tim Horeman have contributed equally to this paper. Electronic supplementary material The online version of this article https://doi.org/10.1007/s00464-020-07898-6 contains supplementary material, which is available to authorized users. * Roelf R. Postema [email protected] Leonie A. van Gastel [email protected] Sem F. Hardon [email protected] H. Jaap Bonjer [email protected] Tim Horeman [email protected] 1
Department of Surgery, University Medical Centers Amsterdam, Location VUMC, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
Faculty of Biomedical Engineering, University of Technology Delft, Mekelweg 2, 2628CD Delft, The Netherlands
2
In the training of laparoscopic surgery residents require more training compared to “open” surgery to successfully refine their sensorimotor system [1] due to the limitations of 2D vision (on the flat video display panel), difficult hand–eye coordination in the small 3D working space and the use of counterintuitive instruments with distorted tactile feedback. Despite rapid technological advancements in the simulators including addition of force tracking and visual or hap
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