title: Haptic feedback in robot-assisted minimally invasive surgery.
abstract: OBJECTIVE
  Robot-assisted minimally invasive surgery (RMIS) holds great promise for improving the accuracy and dexterity of a surgeon and minimizing trauma to the patient. However, widespread clinical success with RMIS has been marginal. It is hypothesized that the lack of haptic (force and tactile) feedback presented to the surgeon is a limiting factor. This review explains the technical challenges of creating haptic feedback for robot-assisted surgery and provides recent results that evaluate the effectiveness of haptic feedback in mock surgical tasks.
  
  
  RESULTS
  Haptic feedback systems for RMIS are still under development and evaluation. Most provide only force feedback, with limited fidelity. The major challenge at this time is sensing forces applied to the patient. A few tactile feedback systems for RMIS have been created, but their practicality for clinical implementation needs to be shown. It is particularly difficult to sense and display spatially distributed tactile information. The cost-benefit ratio for haptic feedback in RMIS has not been established.
  
  
  CONCLUSIONS
  The designs of existing commercial RMIS systems are not conducive for force feedback, and creative solutions are needed to create compelling tactile feedback systems. Surgeons, engineers, and neuroscientists should work together to develop effective solutions for haptic feedback in RMIS.
authors.affiliation: Johns Hopkins University, Department of Mechanical Engineering, Laboratory for Computational Sensing and Robotics, Baltimore, Maryland 21218, USA. aokamura@jhu.edu
authors.forename: Allison M
authors.initials: AM
authors.lastname: Okamura
mesh_terms: D004867:Equipment Design; D005246:Feedback / Q000502:physiology*; D006801:Humans; D013677:Medical Laboratory Science / Q000639:trends; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D012371:Robotics / Q000295:instrumentation*; D055698:Touch Perception / Q000502:physiology*