Sawada Hiroyuki, Egi Hiroyuki, Hattori Minoru, Suzuki Takahisa, Mukai Shoichiro, Kurita Yuichi, Yasui Wataru, Ohdan Hideki
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Advanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Surg Endosc. 2015 Dec;29(12):3811-8. doi: 10.1007/s00464-015-4124-y. Epub 2015 Mar 5.
One of the disadvantages of laparoscopic surgery is its decreased tactile feedback. Surgical experience compensates for the decline in the sense of touch due to an improved ability to process visual information. Stochastic resonance (SR) is known to improve tactile sensation. In this study, we sought to improve the tactile feedback in laparoscopic surgery using SR to safely perform laparoscopic surgery.
Ten surgeons (nine males and one female, age: 30-44 years, median age: 34) with the experiences of >50 laparoscopic surgeries volunteered to participate in this study. We tested the hypothesis that low-level noise applied to the hand can enhance the tactile sensation during surgery. We performed this experiment under three hand conditions (bare-handed conditions, gloved conditions and using the laparoscopic instrument with gloved hands). A piezoelectric actuator that generates vibrations was attached on the radial side of the participant's index finger or to the grip of the laparoscopic instrument. Fine-touch tests were performed using the Semmes-Weinstein test kit. Moreover, we planned laparoscopic suturing and knot-tying tasks in the dry box and using an animal model under controlled vibrations.
In the touch tests using bare hands, gloved hands and the laparoscopic instrument, the mean correct ratio was significantly lower than that observed in the test with no vibrations. Moreover, the OSATS scores for the laparoscopic suturing and knot-tying tasks showed significantly better scores with vibrations.
This technique has a potential to be a great help in establishing safer and high-quality laparoscopic procedures.
腹腔镜手术的缺点之一是触觉反馈减少。手术经验可通过提高处理视觉信息的能力来弥补触觉的下降。随机共振（SR）已知可改善触觉。在本研究中，我们试图利用随机共振改善腹腔镜手术中的触觉反馈，以安全地进行腹腔镜手术。
十名有超过50例腹腔镜手术经验的外科医生（九名男性和一名女性，年龄：30 - 44岁，中位年龄：34岁）自愿参与本研究。我们测试了这样一个假设，即施加于手部的低水平噪声可增强手术过程中的触觉。我们在三种手部条件下（徒手条件、戴手套条件以及戴手套手持腹腔镜器械条件）进行了该实验。一个产生振动的压电致动器附着在参与者食指的桡侧或腹腔镜器械的握把上。使用Semmes - Weinstein测试套件进行精细触觉测试。此外，我们计划在干燥箱中并使用动物模型在受控振动下进行腹腔镜缝合和打结任务。
在徒手、戴手套以及使用腹腔镜器械的触觉测试中，平均正确比率显著低于无振动测试中的比率。此外，腹腔镜缝合和打结任务的OSATS评分在有振动时显示出显著更好的分数。
该技术有可能极大地有助于建立更安全、高质量的腹腔镜手术操作。
