title: The role of visual and direct force feedback in robotics-assisted mitral valve annuloplasty.
abstract: BACKGROUND
  The objective of this work was to determine the effect of both direct force feedback and visual force feedback on the amount of force applied to mitral valve tissue during ex vivo robotics-assisted mitral valve annuloplasty.
  
  
  METHODS
  A force feedback-enabled master-slave surgical system was developed to provide both visual and direct force feedback during robotics-assisted cardiac surgery. This system measured the amount of force applied by novice and expert surgeons to cardiac tissue during ex vivo mitral valve annuloplasty repair.
  
  
  RESULTS
  The addition of visual (2.16 ± 1.67), direct (1.62 ± 0.86), or both visual and direct force feedback (2.15 ± 1.08) resulted in lower mean maximum force applied to mitral valve tissue while suturing compared with no force feedback (3.34 ± 1.93 N; P < 0.05).
  
  
  CONCLUSIONS
  To achieve better control of interaction forces on cardiac tissue during robotics-assisted mitral valve annuloplasty suturing, force feedback may be required.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.|Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.|Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Currie
authors.affiliation: Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Talasaz
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.|Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Reiza
authors.initials: R
authors.lastname: Rayman
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.|Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.|Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: Michael W A
authors.initials: MWA
authors.lastname: Chu
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.|Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.|Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: Bob
authors.initials: B
authors.lastname: Kiaii
authors.affiliation: Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: Terry
authors.initials: T
authors.lastname: Peters
authors.affiliation: Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada.|Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Trejos
authors.affiliation: Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada.|Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.|Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Rajni
authors.initials: R
authors.lastname: Patel
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D004867:Equipment Design; D056228:Feedback, Sensory; D006801:Humans; D058386:Mitral Valve Annuloplasty / Q000295:instrumentation / Q000379:methods*; D008953:Models, Anatomic; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D034421:Sus scrofa; D013536:Suture Techniques / Q000295:instrumentation; D014584:User-Computer Interface
keywords: force feedback; haptics; mitral valve repair; robotics-assisted cardiac surgery