Multi-Sensory Guidance and Feedback for Simulation-Based Training in Robot Assisted Surgery: A Preliminary Comparison of Visual, Haptic, and Visuo-Haptic

Nowadays, robot assisted surgery training relies more and more on computer-based simulation. However, the application of such training technologies is still limited to the early stages of practical training. To broaden the usefulness of simulators, multi-sensory feedback augmentation has been recently investigated. This study aims at combining initial predictive (guidance) and subsequent error-based (feedback) training augmentation in the visual and haptic domain. 32 participants performed 30 repetitions of a virtual reality task resembling needle-driving by using the surgeon console of the da Vinci Research Kit. These trainees were randomly and equally divided into four groups: one group had no training augmentation, while the other groups underwent visual, haptic and visuo-haptic augmentation, respectively. Results showed a significant improvement, initially introduced by guidance, in the task completion capabilities of all the experimental groups against control. In terms of accuracy, the experimental groups outperformed the control group at the end of training. Specifically, visual guidance and haptic feedback played a significant role in error reduction. Further investigations on long term learning could better delineate the optimal combination of guidance and feedback in these sensory domains.

[1]  Peter Kazanzides,et al.  Virtual fixture assistance for needle passing and knot tying , 2016, 2016 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS).

[2]  J. S. Røtnes,et al.  Virtual reality simulator training equals mechanical robotic training in improving robot-assisted basic suturing skills , 2006, Surgical Endoscopy And Other Interventional Techniques.

[3]  David B. Kaber,et al.  Effects of feedback type and modality on motor skill learning and retention , 2019, Behav. Inf. Technol..

[4]  H. Heuer,et al.  Robot assistance of motor learning: A neuro-cognitive perspective , 2015, Neuroscience & Biobehavioral Reviews.

[5]  Karan Rangarajan,et al.  Systematic Review of Virtual Haptics in Surgical Simulation: A Valid Educational Tool? , 2020, Journal of surgical education.

[6]  K. J. Kuchenbecker,et al.  Surgeons and non-surgeons prefer haptic feedback of instrument vibrations during robotic surgery , 2015, Surgical Endoscopy.

[7]  Dorin M. Popovici,et al.  A Survey of Visuo-Haptic Simulation in Surgical Training , 2011, ArXiv.

[8]  David A Cook,et al.  Feedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis , 2013, Advances in Health Sciences Education.

[9]  D. Yuh,et al.  Effects of visual force feedback on robot-assisted surgical task performance. , 2008, The Journal of thoracic and cardiovascular surgery.

[10]  Marcia Kilchenman O'Malley,et al.  Progressive haptic and visual guidance for training in a virtual dynamic task , 2010, 2010 IEEE Haptics Symposium.

[11]  P. Dasgupta,et al.  The role of simulation in urological training - A quantitative study of practice and opinions. , 2016, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[12]  Jeremy D. Brown,et al.  An Evaluation of Inanimate and Virtual Reality Training for Psychomotor Skill Development in Robot-Assisted Minimally Invasive Surgery , 2020, IEEE Transactions on Medical Robotics and Bionics.

[13]  Nima Enayati,et al.  Robotic Assistance-as-Needed for Enhanced Visuomotor Learning in Surgical Robotics Training: An Experimental Study , 2018, 2018 IEEE International Conference on Robotics and Automation (ICRA).

[14]  Heidar Ali Talebi,et al.  Multimodal Sensorimotor Integration for Expert-in-the-Loop Telerobotic Surgical Training , 2018, IEEE Transactions on Robotics.

[15]  Peter Wolf,et al.  Sonification and haptic feedback in addition to visual feedback enhances complex motor task learning , 2014, Experimental Brain Research.

[16]  M. Kibbe,et al.  Status of Simulation-Based Training in Departments of Surgery in the United States. , 2020, The Journal of surgical research.

[17]  Katherine J. Kuchenbecker,et al.  A wrist-squeezing force-feedback system for robotic surgery training , 2017, 2017 IEEE World Haptics Conference (WHC).

[18]  Klaus Radermacher,et al.  Augmentation of haptic feedback for teleoperated robotic surgery , 2020, International Journal of Computer Assisted Radiology and Surgery.

[19]  Alejandra J. Magana,et al.  A Review of Training and Guidance Systems in Medical Surgery , 2020, Applied Sciences.

[20]  R. Schmidt,et al.  Knowledge of results and motor learning: a review and critical reappraisal. , 1984, Psychological bulletin.

[21]  Bin Zheng,et al.  Prevailing Trends in Haptic Feedback Simulation for Minimally Invasive Surgery , 2016, Surgical innovation.

[22]  Chih-Hung King,et al.  Pneumatic balloon actuators for tactile feedback in robotic surgery , 2008, Ind. Robot.

[23]  D. H. Holding,et al.  GUIDANCE, RESTRICTION AND KNOWLEDGE OF RESULTS , 1964 .

[24]  Allison M. Okamura,et al.  Uncontrolled Manifold Analysis of Arm Joint Angle Variability During Robotic Teleoperation and Freehand Movement of Surgeons and Novices , 2014, IEEE Transactions on Biomedical Engineering.

[25]  M. Thaut,et al.  A Review on the Relationship Between Sound and Movement in Sports and Rehabilitation , 2019, Front. Psychol..

[26]  Warren S Grundfest,et al.  Multi-Modal Haptic Feedback for Grip Force Reduction in Robotic Surgery , 2019, Scientific Reports.

[27]  Allison M. Okamura,et al.  Training in divergent and convergent force fields during 6-DOF teleoperation with a robot-assisted surgical system , 2017, 2017 IEEE World Haptics Conference (WHC).

[28]  Heather Carnahan,et al.  Motor Learning Perspectives on Haptic Training for the Upper Extremities , 2014, IEEE Transactions on Haptics.

[29]  Seth Hutchinson,et al.  Customizing haptic and visual feedback for assistive human-robot interface and the effects on performance improvement , 2017, Robotics Auton. Syst..

[30]  S. Maeso,et al.  Efficacy of the Da Vinci Surgical System in Abdominal Surgery Compared With That of Laparoscopy: A Systematic Review and Meta-Analysis , 2010, Annals of surgery.

[31]  Peter Wolf,et al.  The effect of haptic guidance and visual feedback on learning a complex tennis task , 2013, Experimental Brain Research.

[32]  David C Knill,et al.  Visual Feedback Control of Hand Movements , 2004, The Journal of Neuroscience.

[33]  Peter Kazanzides,et al.  An open-source research kit for the da Vinci® Surgical System , 2014, 2014 IEEE International Conference on Robotics and Automation (ICRA).

[34]  Peter Wolf,et al.  Terminal Feedback Outperforms Concurrent Visual, Auditory, and Haptic Feedback in Learning a Complex Rowing-Type Task , 2013, Journal of motor behavior.

[35]  Guang-Zhong Yang,et al.  Active Contraints for Tool-Shaft Collision Avoidance in Minimally Invasive Surgery , 2019, 2019 International Conference on Robotics and Automation (ICRA).

[36]  P. Stricker,et al.  Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. , 2014, European urology.

[37]  Jon C. Gould,et al.  Validation of a virtual reality-based robotic surgical skills curriculum , 2013, Surgical Endoscopy.

[38]  Dmitry Oleynikov,et al.  Real-time augmented feedback benefits robotic laparoscopic training. , 2006, Studies in health technology and informatics.

[39]  Roger Gassert,et al.  Influence of force and torque feedback on operator performance in a VR-based suturing task , 2010 .

[40]  Katherine J. Kuchenbecker,et al.  VerroTouch: High-Frequency Acceleration Feedback for Telerobotic Surgery , 2010, EuroHaptics.