School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK.
Edinburgh Centre for Robotics, Edinburgh, UK.
J Robot Surg. 2024 Nov 7;18(1):401. doi: 10.1007/s11701-024-02150-y.
Minimal-invasive surgery (MIS) and robotic surgery (RS) offer multiple advantages over open surgery (Vajsbaher et al. in Cogn Syst Res 64:08, 2020). However, the lack of haptic feedback is still a limitation. Surgeons learn to adapt to this lack of haptic feedback using visual cues to make judgements about tissue deformation. Experienced robotic surgeons use the visual interpretation of tissue as a surrogate for tactile feedback. The aim of this review is to identify the visual cues that are consciously or unconsciously used by expert surgeons to manipulate soft tissue safely during Minimally Invasive Surgery (MIS) and Robotic Surgery (RS). We have conducted a comprehensive literature review with papers on visual cue identification and their application in education, as well as skill assessment and surgeon performance measurement with respect to visual feedback. To visualise our results, we provide an overview of the state-of-the-art in the form of a matrix across identified research features, where papers are clustered and grouped in a comparative way. The clustering of the papers showed explicitly that state-of-the-art research does not in particular study the direct effects of visual cues in relation to the manipulation of the tissue and training for that purpose, but is more concentrated on tissue identification. We identified a gap in the literature about the use of visual cues for educational design solutions, that aid the training of soft-tissue manipulation in MIS and in RS. There appears to be a need RS education to make visual cue identification more accessible and set it in the context of manipulation tasks.
微创手术 (MIS) 和机器人手术 (RS) 相较于开放性手术 (Vajsbaher 等人,Cogn Syst Res 64:08, 2020) 具有多种优势。然而,缺乏触觉反馈仍然是一个限制。外科医生通过使用视觉线索来判断组织变形,从而学会适应这种缺乏触觉反馈的情况。有经验的机器人外科医生使用组织的视觉解释来替代触觉反馈。本综述旨在确定专家外科医生在微创外科 (MIS) 和机器人外科 (RS) 中安全操纵软组织时有意识或无意识使用的视觉线索。我们进行了全面的文献综述,内容涉及视觉线索识别及其在教育中的应用,以及技能评估和外科医生绩效测量与视觉反馈相关的研究。为了可视化我们的研究结果,我们以矩阵的形式概述了最先进的技术,其中论文按聚类方式进行了比较和分组。论文的聚类明确表明,最先进的研究并没有特别研究视觉线索与组织操纵之间的直接关系,也没有为此目的进行培训,而是更集中于组织识别。我们发现,文献中关于视觉线索在 MIS 和 RS 中的软组织操纵培训中的教育设计解决方案的使用存在空白。似乎需要对 RS 教育进行改进,以便更方便地识别视觉线索,并将其置于操纵任务的背景下。
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