An Adaptive Force Guidance System for Computer-Guided Laparoscopy Training.

We present an adaptive force guidance system for laparoscopic surgery skills training. This system consists of self-adjusting fuzzy sliding-mode controllers and switching mode controllers to provide proper force feedback. Using virtual fixtures, the proposed system restricts motions or guides a trainee to navigate a surgical instrument in a 3-D space in a manner that mimics a human instructor who would teach the trainees by holding their hands. The self-adjusting controllers incorporate human factors, such as different force sensitivity and proficiency levels. The proposed system was implemented and evaluated using the computer-assisted surgical trainer (CAST). The effects of the force guidance system are presented based on the experimental test results.