Catalyzing visual-haptic acuity for tissue handling mastery in robotic minimally invasive surgery

Johns Hopkins University, Baltimore MD

Investigators

Abstract

ABSTRACT A significant portion of the technical errors made by surgical trainees involve the improper use of force on patient tissue. For robotic minimally invasive surgery (RMIS), the improper force problem is exacerbated by the lack of haptic feedback of tool-tissue forces. Expert RMIS surgeons have learned over time to visually estimate these forces in a process known as visual-haptic acuity development. Unfortunately, no training tools currently exist for explicitly catalyzing visual-haptic acuity development in RMIS trainees. The overall objective of this early-stage trailblazer application is to develop and validate an innovative training tool that catalyzes visual-haptic acuity with titrated supplemental haptic feedback. The central hypothesis is that visual-haptic acuity is a critical component of tissue handling skill in RMIS that can be augmented during simulation-based RMIS training using titrated psychomotor-skill specific haptic feedback and assessed using robust measures of tool-tissue interac- tions. The rationale for this project is that tools to support development of visual-haptic acuity provides surgical educators and training institutions with the means to ensure every RMIS surgeon has mastered the tissue han- dling skill necessary to safely operate on patients. The central hypothesis will be tested through the pursuit of two specific aims: 1) Accelerate learning of RMIS visual-haptic acuity using titrated supplemental haptic feedback of tool-tissue forces and tissue-contact accelerations, and 2) Assess and predict RMIS visual-haptic acuity during simulated surgical training. In the first aim, user studies will be conducted to discover and evaluate the optimal haptic feedback titration approach for fostering visual-haptic acuity. In the second aim, structured human grading and data-driven methods will be developed and validated to predict and assess visual-haptic acuity, and the effi- cacy of these approaches will be assessed through surgical task performance on cadaveric tissue. The proposed research is innovative because it focuses explicitly on the development of new tools capable of augmenting and assessing visual-haptic acuity, a critical component of tissue handling skill in RMIS. The proposed research is significant because it will provide an objective, quantifiable, and repeatable means of accelerating tissue handling mastery in RMIS, thereby improving the overall safety of RMIS procedures, regardless of RMIS platform. Suc- cessful completion of these aims therefore enables the creation of validated curricular tools for training the critical psychomotor skills required to reduce iatrogenic tissue injury in RMIS.