Auditory Force Feedback Substitution Improves Surgical Precision during Simulated Ophthalmic Surgery
Auditory Force Feedback Substitution Improves Surgical Precision during Simulated Ophthalmic Surgery
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DOI：
10.1167/iovs.12-11136
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发表时间：
2013-02-01
影响因子：
4.4
通讯作者：
Handa, James T.
中科院分区：
文献类型：
--
作者：
Cutler, Nathan;Balicki, Marcin;Handa, James T.
目的。确定听觉力反馈 (AFF) 替代在模拟眼科剥离过程中改善性能的程度。方法。 25 号力感应微镊子与两种 AFF 模式相连。当力达到 9 mN 时，“警报”AFF 模式会发出声音。“警告”AFF 模式会发出与产生的力成比例的频率的蜂鸣声。具有不同手术经验水平的参与者被要求在不超过 9 mN 的力的情况下尽快从平台上剥离一系列绷带。在研究 A 组中，参与者使用警报和警告 AFF 模式进行剥离，顺序在经验水平内随机化。在研究组 B 中，参与者首先在没有 AFF 的情况下进行剥离，然后发出 AFF 警报或警告（在经验水平内随机排序），最后在没有 AFF 的情况下进行剥离。结果。在 28 名“外科医生”参与者中，AFF 改善了膜剥离性能，降低了产生的平均力 (P < 0.01)、力的 SD (P < 0.05) 和力 X 时间高于 9 mN (P < 0.01)。AFF 的短期训练改善了关闭 AFF 时的后续剥离性能，平均力、力的 SD、最大力、花费在 9 mN 以上的时间以及力 X 时间高于 9 mN （所有 P < 0.001）。完成训练后，使用 AFF 剥离比不使用 AFF 剥离更多地减少了力参数（P < 0.05）。结论：无论手术经验如何，AFF 都可以减少幻膜剥离过程中产生的力，并提高精度。 2013;54:1316-1324) DOI: 10.1167/iovs.12-11136
PURPOSE. To determine the extent that auditory force feedback (AFF) substitution improves performance during a simulated ophthalmic peeling procedure.METHODS. A 25-gauge force-sensing microforceps was linked to two AFF modes. The "alarm'' AFF mode sounded when the force reached 9 mN. The "warning'' AFF mode made beeps with a frequency proportional to the generated force. Participants with different surgical experience levels were asked to peel a series of bandage strips off a platform as quickly as possible without exceeding 9 mN of force. In study arm A, participants peeled with alarm and warning AFF modes, the order randomized within the experience level. In study arm B, participants first peeled without AFF, then alarm or warning AFF (order randomized within the experience level), and finally without AFF.RESULTS. Of the 28 "surgeon'' participants, AFF improved membrane peeling performance, reducing average force generated (P < 0.01), SD of forces (P < 0.05), and force X time above 9 mN (P < 0.01). Short training periods with AFF improved subsequent peeling performance when AFF was turned off, with reductions in average force, SD of force, maximum force, time spent above 9 mN, and force X time above 9 mN (all P < 0.001). Except for maximum force, peeling with AFF reduced all force parameters (P < 0.05) more than peeling without AFF after completing a training session.CONCLUSIONS. AFF enables the surgeon to reduce the forces generated with improved precision during phantom membrane peeling, regardless of surgical experience. New force-sensing surgical tools combined with AFF offer the potential to enhance surgical training and improve surgical performance. (Invest Ophthalmol Vis Sci. 2013;54:1316-1324) DOI: 10.1167/iovs.12-11136