Chmarra Magdalena K, Dankelman Jenny, van den Dobbelsteen John J, Jansen Frank-Willem
Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
Surg Endosc. 2008 Oct;22(10):2140-8. doi: 10.1007/s00464-008-9937-5. Epub 2008 Apr 29.
BACKGROUND: Not much is known about the exact role of force feedback in laparoscopy. This study aimed to determine whether force feedback influences movements of instruments during training in laparoscopic tasks and whether force feedback is required for training in basic laparoscopic force application tasks. METHODS: A group of 19 gynecologic residents, randomly divided into two groups, performed three laparoscopic tasks in both the box trainer and the virtual reality (VR) trainer. The box-VR group began with the box trainer, whereas the VR-box group began with the VR trainer. The three selected tasks included different levels of force application. The box trainer provides natural force feedback, whereas the VR trainer does not provide force feedback. The performance of the two groups was compared with regard to time, path length, and depth perception. RESULTS: For the tasks in which force plays hardly a role, no differences between box-VR group and the VR-box group were found. During a task in which force application (pulling and pushing forces) plays a role, the box-VR group outperformed VR-box group in the box trainer. Moreover, training with the box trainer had a positive effect on subsequent performance of the task with the VR trainer. This was not found the other way around. No differences were found between box-VR and the VR-box group in tasks not requiring force application. CONCLUSION: Force feedback influences basic laparoscopic skills during tasks in which pulling and pushing forces are applied. For these tasks, the switch from the trainer without force feedback to the one with natural force feedback has a detrimental effect on performance. Therefore, training for tasks in which forces play an important role (e.g., stretching, grasping) should be done using systems with natural force feedback, whereas eye-hand coordination can be trained without force feedback.
背景:关于力反馈在腹腔镜检查中的确切作用,目前所知甚少。本研究旨在确定力反馈在腹腔镜任务训练期间是否会影响器械的移动,以及在基本腹腔镜力应用任务训练中是否需要力反馈。 方法:一组19名妇科住院医师被随机分为两组,在箱式训练器和虚拟现实(VR)训练器中执行三项腹腔镜任务。箱式-VR组先使用箱式训练器,而VR-箱式组先使用VR训练器。所选的三项任务包括不同程度的力应用。箱式训练器提供自然力反馈,而VR训练器不提供力反馈。比较两组在时间、路径长度和深度感知方面的表现。 结果:对于力几乎不起作用的任务,箱式-VR组和VR-箱式组之间未发现差异。在一项力应用(拉力和推力)起作用的任务中,箱式-VR组在箱式训练器中的表现优于VR-箱式组。此外,使用箱式训练器进行训练对后续使用VR训练器执行任务有积极影响。反之则未发现此情况。在不需要力应用的任务中,箱式-VR组和VR-箱式组之间未发现差异。 结论:在应用拉力和推力的任务中,力反馈会影响基本的腹腔镜技能。对于这些任务,从无力反馈的训练器切换到具有自然力反馈的训练器会对表现产生不利影响。因此,对于力起重要作用的任务(如拉伸、抓取)的训练应使用具有自然力反馈的系统,而眼手协调可以在无力反馈的情况下进行训练。
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