title: Surgeons and non-surgeons prefer haptic feedback of instrument vibrations during robotic surgery.
abstract: BACKGROUND
  Clinical robotic surgery systems do not currently provide haptic feedback because surgical instrument interactions are difficult to measure and display. Our laboratory recently developed a technology that allows surgeons to feel and/or hear the high-frequency vibrations of robotic instruments as they interact with patient tissue and other tools. Until now, this type of feedback had not been carefully evaluated by users.
  
  
  METHODS
  We conducted two human-subject studies to discover whether surgeons and non-surgeons value the addition of vibration feedback from surgical instruments during robotic surgery. In the first experiment, 10 surgeons and 10 non-surgeons (n = 20) used an augmented Intuitive da Vinci Standard robot to repeatedly perform up to four dry-lab tasks both with and without haptic and audio feedback. In the second experiment, 68 surgeons and 26 non-surgeons (n = 94) tested the same robot at a surgical conference: each participant spent approximately 5 min performing one or two tasks.
  
  
  RESULTS
  Almost all subjects in both experiments (95 and 98 %, respectively) preferred receiving feedback of tool vibrations, and all subjects in the second experiment thought it would be useful for surgeons to have the option of such feedback. About half of the subjects (50, 60 %) preferred haptic and audio feedback together, and almost all the rest (45, 35 %) preferred haptic feedback alone. Subjects stated that the feedback made them more aware of tool contacts and did not interfere with use of the robot. There were no significant differences between the responses of different subject populations for any questions in either experiment.
  
  
  CONCLUSIONS
  This study illustrates that both surgeons and non-surgeons prefer instrument vibration feedback during robotic surgery. Some participants found audio feedback useful but most preferred haptic feedback overall. This strong preference for tool vibration feedback indicates that this technology provides valuable tactile information to the surgeon.
authors.affiliation: Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, 229 Towne Building, 220 S. 33rd Street, Philadelphia, 19104-6315, USA. jackie.koehn@gmail.com.
authors.forename: Jacqueline K
authors.initials: JK
authors.lastname: Koehn
authors.affiliation: Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, 229 Towne Building, 220 S. 33rd Street, Philadelphia, 19104-6315, USA. kuchenbe@seas.upenn.edu.|Department of Computer and Information Science, University of Pennsylvania, Philadelphia, USA. kuchenbe@seas.upenn.edu.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Kuchenbecker
mesh_terms: D001291:Attitude of Health Personnel; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D065287:Robotic Surgical Procedures / Q000295:instrumentation*; D066231:Surgeons; D013525:Surgical Instruments; D014110:Touch; D014732:Vibration
keywords: Audio feedback; Haptic feedback; Robotic surgery; Vibrotactile