Alleblas Chantal C J, Vleugels Michel P H, Stommel Martijn W J, Nieboer Theodoor E
1 Radboud University Medical Center, Nijmegen, Netherlands.
2 Riverland Hospital, Tiel, Netherlands.
Surg Innov. 2019 Oct;26(5):573-580. doi: 10.1177/1553350619848551. Epub 2019 Jun 4.
Compared with open surgery, minimally invasive surgery is limited by reduced sensation of tissue properties. A laparoscopic grasper with integrated haptic feedback technology that improves the ability to sense tissue properties might provide a solution. The force reflecting operation instrument (FROI) is a new laparoscopic grasper, designed to provide information about the interaction forces between the instrument and tissue through resistance in the handle. This pilot study aimed to assess the functionality of the FROI compared with a conventional grasper in an in vivo setting. In this randomized trial, we used a standard laparoscopic surgical setup to perform laparoscopic surgery in pigs. In all, 11 surgeons performed colorectal, gynecological, or urological procedures, once with the FROI and once with a conventional grasper. Participants were asked to complete the NASA Task Load Index Rating Scale and rate 5 specific features for both graspers. To capture opinions on the overall functionality of the FROI, participants were asked to answer 8 open questions. The surgeons reported that the use of the FROI significantly improved tissue consistency perception, arterial pulse detection, and force control compared with the conventional grasper. No significant differences were found in surgeons' muscular strain or operative time. The most emphasized topics in the open questions were improved soft-tissue handling and importance for complex procedures. Through this first in vivo analysis of the functionality of the FROI, a multispecialty group of laparoscopic surgeons confirmed the added value of haptic feedback technology in a live surgical setting.
与开放手术相比，微创手术受到组织特性感知能力下降的限制。一种集成了触觉反馈技术的腹腔镜抓钳，能够提高对组织特性的感知能力，可能会提供一种解决方案。力反馈操作器械（FROI）是一种新型腹腔镜抓钳，旨在通过手柄中的阻力提供器械与组织之间相互作用力的信息。这项初步研究旨在评估在体内环境中FROI与传统抓钳相比的功能。在这项随机试验中，我们使用标准的腹腔镜手术装置对猪进行腹腔镜手术。共有11名外科医生进行了结直肠、妇科或泌尿外科手术，分别使用FROI和传统抓钳各进行一次。参与者被要求完成NASA任务负荷指数评定量表，并对两种抓钳的5个特定特征进行评分。为了收集对FROI整体功能的意见，参与者被要求回答8个开放性问题。外科医生报告称，与传统抓钳相比，使用FROI显著提高了组织一致性感知、动脉搏动检测和力控制能力。在外科医生的肌肉紧张程度或手术时间方面未发现显著差异。开放性问题中最受强调的主题是改善软组织操作以及对复杂手术的重要性。通过对FROI功能的首次体内分析，一组多专业的腹腔镜外科医生证实了触觉反馈技术在实际手术环境中的附加价值。
