Stochastic resonance enhanced tactile feedback in laparoscopic surgery.
BACKGROUND
One of the disadvantages of laparoscopic surgery is its decreased tactile feedback. Surgical experience compensates for the decline in the sense of touch due to an improved ability to process visual information. Stochastic resonance (SR) is known to improve tactile sensation. In this study, we sought to improve the tactile feedback in laparoscopic surgery using SR to safely perform laparoscopic surgery.


METHODS
Ten surgeons (nine males and one female, age: 30-44 years, median age: 34) with the experiences of >50 laparoscopic surgeries volunteered to participate in this study. We tested the hypothesis that low-level noise applied to the hand can enhance the tactile sensation during surgery. We performed this experiment under three hand conditions (bare-handed conditions, gloved conditions and using the laparoscopic instrument with gloved hands). A piezoelectric actuator that generates vibrations was attached on the radial side of the participant's index finger or to the grip of the laparoscopic instrument. Fine-touch tests were performed using the Semmes-Weinstein test kit. Moreover, we planned laparoscopic suturing and knot-tying tasks in the dry box and using an animal model under controlled vibrations.


RESULTS
In the touch tests using bare hands, gloved hands and the laparoscopic instrument, the mean correct ratio was significantly lower than that observed in the test with no vibrations. Moreover, the OSATS scores for the laparoscopic suturing and knot-tying tasks showed significantly better scores with vibrations.


CONCLUSIONS
This technique has a potential to be a great help in establishing safer and high-quality laparoscopic procedures.
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Hiroyuki
H
Sawada
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. hiroegi@yahoo.co.jp.|Advanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. hiroegi@yahoo.co.jp.
Hiroyuki
H
Egi
Advanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Minoru
M
Hattori
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Takahisa
T
Suzuki
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.|Department of Molecular Pathology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Shoichiro
S
Mukai
Department of Engineering, Hiroshima University, Hiroshima, Japan.
Yuichi
Y
Kurita
Department of Molecular Pathology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Wataru
W
Yasui
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Hideki
H
Ohdan
D000328:Adult; D002983:Clinical Competence; D056228:Feedback, Sensory; D005260:Female; D006225:Hand / Q000502:physiology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011897:Random Allocation; D013269:Stochastic Processes; D014110:Touch; D014732:Vibration
Laparoscopic surgery; Objective assessment; Surgical skills; Tactile feedback