Brydges R, Carnahan H, Dubrowski A
Department of Surgery, University of Toronto, Surgical Skills Centre and The Wilson Centre, 200 Elizabeth Street, Eaton South 1E S83, Toronto, Ontario, Canada, M5G 1X5.
Ergonomics. 2005 Jun 10;48(7):874-94. doi: 10.1080/00140130500123704.
During laparoscopic surgery video images are used to guide the movements of the hand and instruments, and objects in the operating field often obscure these images. Thus, surgeons often rely heavily on tactile information (sense of touch) to help guide their movements. It is important to understand how tactile perception is affected when using laparoscopic instruments, since many surgical judgements are based on how a tissue 'feels' to the surgeon, particularly in situations where visual inputs are degraded. Twelve naïve participants used either their index finger or a laparoscopic instrument to explore sandpaper surfaces of various grits (60, 100, 150 and 220). These movements were generated with either vision or no vision. Participants were asked to estimate the roughness of the surfaces they explored. The normal and tangential forces of either the finger or instrument on the sandpaper surfaces were measured. Results showed that participants were able to judge the roughness of the sandpaper surfaces when using both the finger and the instrument. However, post hoc comparisons showed that perceptual judgements of surface texture were altered in the no vision condition compared to the vision condition. This was also the case when using the instrument, compared to the judgements provided when exploring with the finger. This highlights the importance of the completeness of the video images during laparoscopic surgery. More normal and tangential force was used when exploring the surfaces with the finger as opposed to the instrument. This was probably an attempt to increase the contact area of the fingertip to maximize tactile input. With the instrument, texture was probably sensed through vibrations of the instrument in the hand. Applications of the findings lie in the field of laparoscopic surgery simulation techniques and tactile perception.
在腹腔镜手术中，视频图像用于指导手部和器械的动作，而手术区域中的物体常常会遮挡这些图像。因此，外科医生常常严重依赖触觉信息（触觉）来辅助指导他们的动作。了解使用腹腔镜器械时触觉感知是如何受到影响很重要，因为许多手术判断是基于组织给外科医生的“感觉”，特别是在视觉输入变差的情况下。12名没有经验的参与者用食指或腹腔镜器械探索不同粒度（60、100、150和220）的砂纸表面。这些动作在有视觉或无视觉的情况下进行。要求参与者估计他们所探索表面的粗糙度。测量手指或器械在砂纸表面上的法向力和切向力。结果表明，参与者在使用手指和器械时都能够判断砂纸表面的粗糙度。然而，事后比较表明，与有视觉的情况相比，在无视觉的情况下表面纹理的感知判断发生了改变。与用手指探索时的判断相比，使用器械时也是如此。这突出了腹腔镜手术期间视频图像完整性的重要性。与使用器械相比，用手指探索表面时使用了更多的法向力和切向力。这可能是为了增加指尖的接触面积以最大化触觉输入。使用器械时，纹理可能是通过器械在手中的振动来感知的。这些发现的应用在于腹腔镜手术模拟技术和触觉感知领域。
