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Assisting Control of Forces in Laparoscopy Using Tactile and Visual Sensory Substitution

机译:使用触觉和视觉感觉替代控制腹腔镜检查中力量的控制

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It is widely recognized that despite its many benefits, the ergonomics of laparoscopic surgery lead to severe perceptual distortions for the surgeon. In particular, interaction forces at the instrument tip are masked by interfering forces at the trocar and distorted due to a lever effect around the insertion point. This leads to improper control of tool-tip interaction forces, increasing the risk and occurrence of intra-operative injuries, unnecessary trauma to healthy tissue and suture breakage. Here, we propose an experiment aimed at determining the efficacy and usability of cutaneous vibrotactile and/or visual feedback of tool-tip interaction forces in assisting a surgeon in controlling fine interaction forces. 16 novice subjects performed force-reach and -hold tasks in a laparoscopic setting under provision of 9 forms of feedback (visual, 4 variants of vibrotactile feedback, and their combinations). Feed-back increased precision (up to 85.8 % reduction in error when aiming for a target force), repeatability (up to 84 % reduction in spread of aiming errors), speed of reaching a target force (up to 18-fold increase in speed of reaching a target force at equal accuracy) and reduced force drift over time (>68 % reduction in cumulative deviation from a target force over a 20 s period). Results show best performance for visual feedback, with promising performance for pulsed vibrotactile feedback, allowing us to draw initial conclusions on the potential for using tactile feedback to represent interaction forces in laparoscopy and to gain insights into axes for its improvement.
机译:人们普遍认识到,尽管有诸多好处,腹腔镜手术导致的人体工程学设计,为外科医生严重的知觉扭曲。特别地,在器械末端相互作用力由在套管针干扰力掩蔽和歪曲由于绕插入点的杠杆作用。这将导致不正确的控制工具提示的相互作用力,增加术中损伤,不必要的损伤健康组织和缝线断裂的风险和发生。在这里,我们提出了旨在确定在控制精细相互作用力协助外科医生的皮肤振动触觉和/或工具提示相互作用力的视觉反馈的有效性和易用性的实验。 16名新手受试者下提供9种形式的反馈(视觉,振动触觉的反馈4点的变体,以及它们的组合)来进行力接触到和-hold任务在腹腔镜设置。反馈(瞄准当用于目标力高达误差减少85.8%)(以瞄准误差的传播最多减少84%),达到了目标力的速度(高达速度18倍的增加提高的精度,可重复性随着时间的推移到达以相等的精度的目标力)和还原力漂移(的>在累积偏差减少68%从目标力在20秒周期)。结果显示视觉反馈最佳性能,与脉冲振动触觉反馈,让我们对潜在得出初步结论利用触觉反馈来表示腹腔镜相互作用力,并深入了解其改进轴有前途的性能。

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