title: Effects of realistic force feedback in a robotic assisted minimally invasive surgery system.
abstract: BACKGROUND
  Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion.
  
  
  METHODS
  A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results.
  
  
  RESULTS
  Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers.
  
  
  CONCLUSIONS
  The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in robotic assisted minimally invasive surgery operations.
authors: Centre for Intelligent Systems Research (CISR), Deakin University , Waurn Ponds Australia.
authors: Mohsen
authors: M
authors: Moradi Dalvand
authors: Bijan
authors: B
authors: Shirinzadeh
authors: Saeid
authors: S
authors: Nahavandi
authors: Julian
authors: J
authors: Smith
mesh_terms: D004867:Equipment Design; D005246:Feedback; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010173:Palpation; D012371:Robotics / Q000379:methods*; D018709:Statistics, Nonparametric; D014110:Touch
keywords: Cochran's Q test; Friedman test; Haptics; Robotic Assisted Minimally Invasive Surgery (RAMIS); Wilcoxon signed-rank test; surgical instrument; tissue characterization