Unger Bertram, Sepehri Nariman, Rampersad Vivek, Pisa Justyn, Hochman Jordan B
Department of Medical Education University of Manitoba Winnipeg Manitoba Canada.
Faculty of Engineering University of Manitoba Winnipeg Manitoba Canada.
Laryngoscope Investig Otolaryngol. 2017 Nov 2;2(6):358-362. doi: 10.1002/lio2.120. eCollection 2017 Dec.
Temporal bone simulations are critiqued for poor drill-bone interaction. This project appraises the import of increasing haptic device and manipulandum fidelity on the perceived realism of drilling a virtual temporal bone.Virtual surgical contact forces rely on haptic device fidelity and are transmitted through a manipulandum. With identical software, both device hardware and manipulandum may each contribute to realism. We compare the three degrees of freedom (DOF), 3N Geomagic Touch (3D Systems, SC) to a 6DOF, 5.5N HD (Quanser, ON) with the both standard ("HD-Standard") and in-house customized otic drill manipulandum ("HD-Modified").
Six otologic surgeons performed three virtual mastoidectomy surgeries on a temporal bone surgical simulator. The HD manipulandum was modified for attached otic drill with gravity compensation and requisite mechanical modifications. Surgeons, in random order, performed the dissection with the different hardware platforms.
Two-tailed t-tests demonstrate that for the of each simulation, the HD-Modified manipulandum was favored ( ≤ 0.0004). For , both HD-Standard ( ≤ 0.05) HD-Modified ( ≤ 0.03)) were favored over the Geomagic; however they were not appreciably different when directly compared to each other. There was no preference for increasing haptic device fidelity in virtual drill bone interaction.In forced rank, users favored the HD-Modified in osseus, vibrational and overall realism, as well as being preferred for education and preoperative rehearsal ( ≤ 0.0164).
Increasing manipulandum realism was favored. However surprisingly, there was no preference for increased device fidelity, illustrating incremental stiffness had nominal impact. There may be a ceiling to drill bone interaction in virtual haptic simulation.
2b.
颞骨模拟因钻头与骨骼的交互不佳而受到批评。本项目评估增加触觉设备和操作手柄逼真度对虚拟颞骨钻孔逼真感的影响。虚拟手术接触力依赖于触觉设备的逼真度，并通过操作手柄传递。在软件相同的情况下，设备硬件和操作手柄都可能影响逼真感。我们将三自由度（DOF）、3N的Geomagic Touch（3D Systems公司，南卡罗来纳州）与六自由度、5.5N的HD（Quanser公司，安大略省），分别与标准的（“HD标准型”）和内部定制的耳科钻头操作手柄（“HD改良型”）进行比较。
六位耳科外科医生在颞骨手术模拟器上进行了三次虚拟乳突切除术。对HD操作手柄进行了改良，以适配耳科钻头，并具备重力补偿和必要的机械改装。外科医生以随机顺序使用不同的硬件平台进行解剖。
双尾t检验表明，对于每次模拟的[具体指标未明确]，HD改良型操作手柄更受青睐（P≤0.0004）。对于[另一具体指标未明确]，HD标准型（P≤0.05）和HD改良型（P≤0.03）均比Geomagic更受青睐；然而，当直接相互比较时，它们之间没有明显差异。在虚拟钻孔与骨骼交互中，对于提高触觉设备逼真度没有偏好。在强制排序中，用户在骨质、振动和整体逼真感方面更青睐HD改良型，在教育和术前预演方面也更倾向于它（P≤0.0164）。
提高操作手柄的逼真度更受青睐。然而，令人惊讶的是，对于提高设备逼真度没有偏好，说明增加的刚度影响不大。在虚拟触觉模拟中，钻孔与骨骼的交互可能存在上限。
2b。
