Mechanical Engineering Department, Tufts University, 200 College Avenue, Medford, MA 02155, USA.
Surg Endosc. 2012 Apr;26(4):1128-34. doi: 10.1007/s00464-011-2011-8. Epub 2011 Nov 2.
The benefits of haptic feedback in laparoscopic surgery training simulators is a topic of debate in the literature. It is hypothesized that novice surgeons may not benefit from the haptic information, especially during the initial phase of learning a new task. Therefore, provision of haptic feedback to novice trainees in the early stage of training may be distracting and detrimental to learning. A controlled experiment was conducted to examine the effect of haptic feedback on the learning curve of a complex laparoscopic suturing and knot-tying task.
The ProMIS and the MIST-VR surgical simulators were used to represent conditions with and without haptic feedback, respectively. A total of 20 novice subjects (10 per simulator) were trained to perform suturing and knot-tying and practiced the tasks in 18 sessions of 1 h each.
At the end of the 3-week training period, the subjects performed equally fast but more consistently with haptics (ProMIS) than without haptics (MIST-VR). The subjects showed a slightly higher learning rate and reached the first plateau of the learning curve earlier with haptic feedback.
In general, learning with haptic feedback was significantly better than learning without it for a laparoscopic suturing and knot-tying task, but only during the first 5 h of training. Haptic feedback may not be warranted in laparoscopic surgical trainers. The benefits of a shorter time to the first performance plateau and more consistent initial performance should be balanced with the cost of implementing haptic feedback in surgical simulators.
在腹腔镜手术模拟器中使用触觉反馈的好处在文献中存在争议。有假设认为新手外科医生可能无法从触觉信息中受益，尤其是在学习新任务的初始阶段。因此，在培训的早期阶段向新手学员提供触觉反馈可能会分散注意力，不利于学习。进行了一项对照实验，以检验触觉反馈对复杂腹腔镜缝合和打结任务学习曲线的影响。
使用 ProMIS 和 MIST-VR 手术模拟器分别代表具有和不具有触觉反馈的条件。总共 20 名新手受试者（每个模拟器 10 名）接受了缝合和打结的培训，并在 18 个 1 小时的训练课程中练习了这些任务。
在 3 周的培训期结束时，有触觉反馈（ProMIS）的受试者完成任务的速度与没有触觉反馈（MIST-VR）的受试者一样快，但完成任务的一致性更高。受试者的学习速度略高，并且在使用触觉反馈的情况下更早地达到了学习曲线的第一个平台。
一般来说，对于腹腔镜缝合和打结任务，使用触觉反馈进行学习明显优于不使用触觉反馈，但仅在训练的前 5 小时内如此。在腹腔镜外科训练器中可能不需要触觉反馈。与在外科模拟器中实施触觉反馈的成本相比，应权衡更短的时间到达第一个性能平台和更一致的初始性能的好处。
