The influence of force feedback and visual feedback in grasping tissue laparoscopically
The influence of force feedback and visual feedback in grasping tissue laparoscopically
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DOI：
10.1007/s00464-003-9244-0
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发表时间：
2004-06-01
影响因子：
3.1
通讯作者：
Gouma, DJ
中科院分区：
文献类型：
--
作者：
Heijnsdijk, EAM;Pasdeloup, A;Gouma, DJ
背景：由于腹腔镜器械提供的力反馈有限，外科医生可能难以在组织上施加适当的力。本研究的目的是确定力反馈和视觉反馈对所施加的捏力的影响。方法：开发了一种在钳口中带有力传感器的抓握器。有或没有腹腔镜经验的受试者用 5 N 的力抓住并拉动猪肠。在 1 秒和 1 分钟持续时间的任务中测量所施加的捏力。一半的测量提供了视觉反馈。通过将镊子的机械效率从 30% 更改为 90% 来调整力反馈。结果：施加的平均夹紧力为 6.8 N (+/-0.5)，而防止滑动的力为 3.0 N (+/-0.4)。提高机械效率对 1 秒测量的夹紧力没有影响。机械效率为 30% 时，夹持组织 1 分钟时的过度夹紧力低于 90% 时（105% 与 131%，p = 0.04）。当受试者没有视觉反馈时，组织滑动的频率更高（2% vs 8%，p = 0.02）。结论：在用腹腔镜钳抓取组织的任务中，力反馈和视觉反馈的作用比预期的作用更有限。
Background: Due to the limited force feedback provided by laparoscopic instruments, surgeons may have difficulty in applying the appropriate force on the tissue. The aim of this study was to determine the influence of force feedback and visual feedback on the exerted pinch force.Methods: A grasper with a force sensor in the jaws was developed. Subjects with and without laparoscopic experience grasped and pulled pig bowel with a force of 5 N. The applied pinch force was measured during tasks of 1-s and 1-min duration. Visual feedback was provided in half the measurements. Force feedback was adjusted by changing the mechanical efficiency of the forceps from 30% to 90%.Results: The mean pinch force applied was 6.8 N (+/-0.5), whereas the force to prevent slippage was 3.0 N (+/-0.4). Improving the mechanical efficiency had no effect on the pinch force for the 1-s measurements. The amount of excessive pinch force when holding tissue for 1 min was lower at 30% mechanical efficiency compared with 90% (105% vs 131%, p = 0.04). The tissue slipped more often when the subject had no visual feedback (2% vs 8%, p = 0.02).Conclusion: Force feedback and visual feedback play a more limited role than expected in the task of grasping tissue with laparoscopic forceps.