Department of Bioengineering, Christian Medical College Vellore, Tamil Nadu, India; Department of Biotechnology, Indian Institute of Technology Madras, Tamil Nadu, India.
Medical Sciences Group, University of Pelita Harapan Medical Sciences, Tangerang, Indonesia.
Int J Surg. 2015 Jun;18:211-5. doi: 10.1016/j.ijsu.2015.04.078. Epub 2015 Apr 30.
The design of good virtual simulators for laparoscopic training requires realistic visual and tactile perception. This is a study to characterize the factors that contribute to forces during laparoscopic pinching.
Surgeons were divided into four groups according to years of experience in laparoscopic surgery. They were asked to grasp six different types of porcine abdominal tissue in a randomly sequenced manner, using two different types of sensorized graspers, under two regimes of perceptual feedback (with and without visual feedback). The forces (grasper handle force and grasper tip force) and grasper handle angle were recorded and analyzed.
The factors that determine forces during laparoscopic pinching can be ranked as follows: surgical experience (p < .001), tissue type (p = .007) and visual feedback (p = .033), but not grasper type (p = .071). Handle force depends significantly on surgical experience (p < .001), tissue type (p = .001) and visual feedback (p = .019), but not on grasper type (p = .203). Tip force depends significantly on surgical experience (p < .001) and marginally on tissue type (p = .082) and visual feedback (p = .053) but not on the grasper type (p = .180).
Forces during laparoscopic pinching depend on surgical experience, tissue type and presence of visual feedback but not on grasper type. Our data can be an input in the design of virtual simulators with force feedback, for training laparoscopic pinching.
设计用于腹腔镜培训的良好虚拟模拟器需要逼真的视觉和触觉感知。本研究旨在确定影响腹腔镜夹捏力的因素。
根据腹腔镜手术经验的不同，将外科医生分为四组。他们被要求以随机顺序使用两种不同类型的带传感器抓握器抓取六种不同类型的猪腹部组织，在两种感知反馈（有和没有视觉反馈）模式下进行。记录和分析力（抓握器手柄力和抓握器尖端力）和抓握器手柄角度。
决定腹腔镜夹捏力的因素可以按以下顺序排列：手术经验（p<0.001）、组织类型（p=0.007）和视觉反馈（p=0.033），而不是抓握器类型（p=0.071）。手柄力显著取决于手术经验（p<0.001）、组织类型（p=0.001）和视觉反馈（p=0.019），但与抓握器类型无关（p=0.203）。尖端力显著取决于手术经验（p<0.001），略取决于组织类型（p=0.082）和视觉反馈（p=0.053），但与抓握器类型无关（p=0.180）。
腹腔镜夹捏力取决于手术经验、组织类型和视觉反馈的存在，但与抓握器类型无关。我们的数据可为带力反馈的腹腔镜夹捏虚拟模拟器的设计提供依据。
