In vivo validation of a system for haptic feedback of tool vibrations in robotic surgery
In vivo validation of a system for haptic feedback of tool vibrations in robotic surgery
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DOI：
10.1007/s00464-012-2452-8
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发表时间：
2013-02-01
影响因子：
3.1
通讯作者：
Kuchenbecker, Katherine J.
中科院分区：
文献类型：
--
作者：
Bark, Karlin;McMahan, William;Kuchenbecker, Katherine J.
机器人微创手术 (RMIS) 缺乏外科医生习惯于在开放式和腹腔镜手术中接收的触觉（动觉和触觉）提示。我们之前介绍了一种向 RMIS 系统添加工具振动的触觉和音频反馈的方法，创造类似于使用腹腔镜工具时的感觉和听到的感觉。我们之前的工作表明，执行盒子训练器任务的外科医生明显更喜欢获得这种反馈，并相信这有助于他们专注于任务，但我们不知道我们的方法在临床相关环境中的效果如何。这项研究构成了我们系统的首次体内测试。测量工具振动的加速度计安装在达芬奇 S 手术系统的患者侧机械臂上。测量到的振动被记录下来并通过振动触觉和音频通道呈现给外科医生，同时在猪模型上完成了两次经腹膜肾切除术和两次输尿管中段输尿管切开术。我们检查了 30 分钟的视频，以识别和标记操作事件，旨在确定我们的系统是否可以在体内手术过程中测量显着且有意义的工具振动。总共识别了 1,404 个操作事件。对每个事件的加速度的分析表明，82% 的事件导致了显着的振动。不同操作事件测量到的加速度大小差异很大，其中硬接触引起的影响最大。这项研究证明了在体内 RMIS 期间提供工具振动反馈的可行性。在猪模型上进行标准泌尿外科手术期间，对大多数事件的显着工具振动进行了可靠测量，同时向外科医生提供了实时、自然的触觉和音频工具振动反馈。反馈系统的模块可以在达芬奇 S 的无菌区域外轻松实施，并且不会干扰手术过程。
Robotic minimally invasive surgery (RMIS) lacks the haptic (kinesthetic and tactile) cues that surgeons are accustomed to receiving in open and laparoscopic surgery. We previously introduced a method for adding tactile and audio feedback of tool vibrations to RMIS systems, creating sensations similar to what one feels and hears when using a laparoscopic tool. Our prior work showed that surgeons performing box-trainer tasks significantly preferred having this feedback and believed that it helped them concentrate on the task, but we did not know how well our approach would work in a clinically relevant setting. This study constituted the first in vivo test of our system.Accelerometers that measure tool vibrations were mounted to the patient-side manipulators of a da Vinci S surgical system. The measured vibrations were recorded and presented to the surgeon through vibrotactile and audio channels while two transperitoneal nephrectomies and two mid-ureteral dissections with uretero-ureterostomy were completed on a porcine model. We examined 30 minutes of resulting video to identify and tag manipulation events, aiming to determine whether our system can measure significant and meaningful tool vibrations during in vivo procedures.A total of 1,404 manipulation events were identified. Analysis of each event's accelerations indicated that 82 % of these events resulted in significant vibrations. The magnitude of the accelerations measured for different manipulation events varied widely, with hard contact causing the largest cues.This study demonstrates the feasibility of providing tool vibration feedback during in vivo RMIS. Significant tool vibrations were reliably measured for the majority of events during standard urological procedures on a porcine model, while real-time, naturalistic tactile and audio tool vibration feedback was provided to the surgeon. The feedback system's modules were easily implemented outside the sterile field of the da Vinci S and did not interfere with the surgical procedure.