Perception of Stiffness in Laparoscopy - the Fulcrum Effect

We explored how the perception of stiffness can be distorted in Minimally Invasive Surgery. We combined a mechanical simulator with a haptic device, and implemented linear springs at the tip of the simulated laparoscopic device. To explore the influence of mechanical advantage on perception, we set different values of the ratio between internal and external length of the tool. We found that a nonsymmetrical ratio causes bias in the perceived stiffness when novice tangential probing is compared to radial probing. In contrast, haptic experts did not show similar perceptual bias.

[1]  D. Theodorescu,et al.  Status of robotic cystectomy in 2005 , 2006, World Journal of Urology.

[2]  L. Way,et al.  Causes and Prevention of Laparoscopic Bile Duct Injuries: Analysis of 252 Cases From a Human Factors and Cognitive Psychology Perspective , 2003, Annals of surgery.

[3]  F A Wichmann,et al.  Ning for Helpful Comments and Suggestions. This Paper Benefited Con- Siderably from Conscientious Peer Review, and We Thank Our Reviewers the Psychometric Function: I. Fitting, Sampling, and Goodness of Fit , 2001 .

[4]  Dogu Teber,et al.  Mechanical simulators for training for laparoscopic surgery in urology. , 2007, Journal of endourology.

[5]  S. Nakada,et al.  Hand assisted laparoscopic nephrectomy: comparison to standard laparoscopic nephrectomy. , 1998, The Journal of urology.

[6]  Mi Zhou,et al.  Force perception threshold varies with experience in minimally invasive surgery , 2007, 2007 IEEE International Conference on Systems, Man and Cybernetics.

[7]  C D Smith,et al.  Assessing laparoscopic manipulative skills. , 2001, American journal of surgery.

[8]  C. Cao,et al.  Role of Haptic Feedback and Cognitive Load in Surgical Skill Acquisition , 2007 .

[9]  Ferdinando A. Mussa-Ivaldi,et al.  A Regression and Boundary-Crossing-Based Model for the Perception of Delayed Stiffness , 2008, IEEE Transactions on Haptics.

[10]  Christopher R. Wagner,et al.  The Benefit of Force Feedback in Surgery: Examination of Blunt Dissection , 2007, PRESENCE: Teleoperators and Virtual Environments.

[11]  J. Dankelman,et al.  Haptics in minimally invasive surgery – a review , 2008, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[12]  C. Daniel Smith,et al.  Bile Duct Injury During Laparoscopic Cholecystectomy: Results of a National Survey , 2001, Annals of surgery.

[13]  Ilana Nisky,et al.  Proximodistal gradient in the perception of delayed stiffness , 2009 .

[14]  R. Satava,et al.  Virtual reality as a metric for the assessment of laparoscopic psychomotor skills , 2002, Surgical Endoscopy And Other Interventional Techniques.

[15]  A. Gallagher,et al.  An ergonomic analysis of the fulcrum effect in the acquisition of endoscopic skills. , 1998, Endoscopy.

[16]  D. Deziel,et al.  Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. , 1993, American journal of surgery.

[17]  A. Gallagher,et al.  Experienced laparoscopic surgeons are automated to the "fulcrum effect": an ergonomic demonstration. , 1999, Endoscopy.

[18]  A Dubrowski,et al.  Surface exploration using laparoscopic surgical instruments: The perception of surface roughness , 2005, Ergonomics.

[19]  J. Svanvik,et al.  Impact of virtual reality-simulated training on urology residents' performance of transurethral resection of the prostate. , 2010, Journal of endourology.