title: The effect of visual and haptic feedback on computer-assisted needle insertion.
abstract: OBJECTIVE
  We present a study evaluating the effects of visual and haptic feedback on human performance in a needle insertion task.
  
  
  METHODS
  A one-degree-of-freedom needle insertion simulator with a three-layer tissue model (skin, fat and muscle) was used in perceptual experiments. The objective of the 14 subjects was to detect the puncture of each tissue layer using varying haptic and visual cues. Performance was measured by overshoot error-the distance traveled by the virtual needle after puncture.
  
  
  RESULTS
  Without force feedback, real-time visual feedback reduced error by at least 87% in comparison to static image overlay. Force feedback, in comparison to no force feedback, reduced puncture overshoot by at least 52% when visual feedback was absent or limited to static image overlay. A combination of force and visual feedback improved performance, especially for tissues with low stiffness, by at least 43% with visual display of the needle position, and by at least 67% with visual display of layer deflection.
  
  
  CONCLUSIONS
  Real-time image overlay significantly enhances controlled puncture during needle insertion. Force feedback may not be necessary except in circumstances where visual feedback is limited.
authors.affiliation: EBI, L. P., Parsippany, New Jersey, USA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Gerovich
authors.forename: Panadda
authors.initials: P
authors.lastname: Marayong
authors.forename: Allison M
authors.initials: AM
authors.lastname: Okamura
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D009339:Needles; D011300:Preoperative Care; D011677:Punctures / Q000379:methods*; D013647:Task Performance and Analysis; D014584:User-Computer Interface