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

机译:使用触觉和视觉感官替代辅助腹腔镜检查中的力量

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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:众所周知,尽管存在许多益处,但腹腔镜手术的人体工程学导致外科医生的严重感知扭曲。特别地,仪器尖端处的相互作用力通过干扰套管针处的力而被掩蔽,并且由于围绕插入点的杠杆效应而变形。这导致工具尖端相互作用力的控制不当,增加了术中损伤的风险和发生,对健康组织和缝合破裂的不必要的创伤。在这里,我们提出了一种旨在确定皮肤振动和/或刀尖相互作用力的疗效和可用性在控制细互动力的外科医生时的效果和可用性的实验。 16项新手受试者在提供9种形式的反馈(视觉,4种变种的振动反馈和它们的组合)下进行腹腔镜设置中的力量达到和 - 持有的任务。反馈提高精度(瞄准目标力时出现误差的误差高达85.8%),可重复性(瞄准误差传播的高达84%),达到目标力的速度(速度高达18倍以相同的精度达到目标力),并且减少力随时间漂移(>从20S期间累积偏差的累积偏差68%)。结果显示可视化反馈的最佳性能,具有脉冲振动反馈的有希望的性能,允许我们利用触觉反馈的可能性结论,以表示腹腔镜检查中的相互作用力,并为其改进进入轴的洞察力。

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