title: Hand-tool-tissue interaction forces in neurosurgery for haptic rendering.
abstract: Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives. This work focuses on checking whether the interaction forces during a bench model neurosurgery operation can lie in the solely cutaneous perception of the human finger pads. If this assumption is found true, it would be possible to exploit sensory subtraction techniques for providing surgeons with feedback from neurosurgery. We measured the forces exerted to surgical tools by three neurosurgeons performing typical actions on a brain phantom, using contact force sensors, while the forces exerted by the tools to the phantom tissue were recorded using a load cell placed under the brain phantom box. The measured surgeon-tool contact forces were 0.01-3.49 N for the thumb and 0.01-6.6 N for index and middle finger, whereas the measured tool-tissue interaction forces were from six to 11 times smaller than the contact forces, i.e., 0.01-0.59 N. The measurements for the contact forces fit the range of the cutaneous sensitivity for the human finger pad; thus, we can say that, in a tele-operated robotic neurosurgery scenario, it would possible to render forces at the fingertip level by conveying haptic cues solely through the cutaneous channel of the surgeon's finger pads. This approach would allow high transparency and high stability of the haptic feedback loop in a tele-operation system.
authors.affiliation: Department of Information Engineering and Mathematics, University of Siena, Via Roma 56, 53100, Siena, Italy. aggravi@dii.unisi.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Aggravi
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: De Momi
authors.affiliation: National Neurological Institute "C. Besta", Via Celoria 11, 20133, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: DiMeco
authors.affiliation: "Claudio Munari" Epilepsy and Parkinson Surgery Centre, Niguarda Ca Granda Hospital, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardinale
authors.affiliation: "Claudio Munari" Epilepsy and Parkinson Surgery Centre, Niguarda Ca Granda Hospital, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Casaceli
authors.affiliation: Unità of Oncological Neurosurgery Humanitas Research Hospital, Università degli Studi di Milano, via Manzoni 56, 20089, Rozzano, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Riva
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ferrigno
authors.affiliation: Department of Information Engineering and Mathematics, University of Siena, Via Roma 56, 53100, Siena, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Prattichizzo
mesh_terms: D001921:Brain; D004867:Equipment Design; D005246:Feedback; D005385:Fingers / Q000502:physiology; D006225:Hand / Q000502:physiology*; D006801:Humans; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D012815:Signal Processing, Computer-Assisted; D066231:Surgeons; D013523:Surgical Equipment
keywords: Brain phantom forces; Contact forces; Haptic rendering; Neurosurgery