Huang Felix C, Pugh Carla M, Patton James L, Mussa-Ivaldi Ferdinando A
Department of Biomedical Engineering, Northwestern University, 345 East Superior St., Room 1308, Chicago, IL 60611, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2097-102. doi: 10.1109/IEMBS.2010.5626188.
We devised an interactive environment in which subjects could perform simulated laparoscopic maneuvers, using either unconstrained movements or standard mechanical contact typical of a box-trainer. During training the virtual tool responded to the absolute position in space (Position-Based) or the orientation (Orientation-Based) of a hand-held sensor. Volunteers were further assigned to different sequences of target distances (Near-Far-Near or Far-Near-Far). Orientation-Based control produced much lower error and task times during training, which suggests that the motor system more easily accommodates tool use with degrees of freedom that match joint angles. When evaluated in constrained (physical box-trainer) conditions, each group exhibited improved performance from training. However, Position-Based training enabled greater reductions in movement error relative to Orientation-Based (mean -13.7%, CI:-27.1, -0.4). Furthermore, the Near-Far-Near schedule allowed a greater decrease in task time relative to the Far-Near-Far sequence (mean -13.5%, CI:-19.5, -7.5). Training at shallow insertion in virtual laparoscopy might promote more efficient movement strategies by emphasizing the curvature of tool motion. In addition, our findings suggest that an understanding of absolute tool position is critical to coping with mechanical interactions between the tool and trochar.
我们设计了一个交互式环境，受试者可以在其中使用无约束运动或典型的箱式训练器的标准机械接触来执行模拟腹腔镜操作。在训练过程中，虚拟工具对手持传感器在空间中的绝对位置（基于位置）或方向（基于方向）做出响应。志愿者还被分配到不同的目标距离序列（近-远-近或远-近-远）。基于方向的控制在训练期间产生的误差和任务时间要低得多，这表明运动系统更容易适应与关节角度相匹配的自由度的工具使用。在受限（物理箱式训练器）条件下进行评估时，每个组的训练表现都有所提高。然而，相对于基于方向的训练，基于位置的训练能够更大程度地减少运动误差（平均-13.7%，CI：-27.1，-0.4）。此外，相对于远-近-远序列，近-远-近时间表允许任务时间有更大程度的减少（平均-13.5%，CI：-19.5，-7.5）。在虚拟腹腔镜检查中进行浅插入训练可能通过强调工具运动的曲率来促进更有效的运动策略。此外，我们的研究结果表明，了解工具的绝对位置对于应对工具与套管针之间的机械相互作用至关重要。
