title: Visual-perceptual mismatch in robotic surgery.
abstract: The principal objective of the experiment was to analyze the effects of the clutch operation of robotic surgical systems on the performance of the operator. The relative coordinate system introduced by the clutch operation can introduce a visual-perceptual mismatch which can potentially have negative impact on a surgeon's performance. We also assess the impact of the introduction of additional tactile sensory information on reducing the impact of visual-perceptual mismatch on the performance of the operator.
  
  
  
  We asked 45 novice subjects to complete peg transfers using the da Vinci IS 1200 system with grasper-mounted, normal force sensors. The task involves picking up a peg with one of the robotic arms, passing it to the other arm, and then placing it on the opposite side of the view. Subjects were divided into three groups: aligned group (no mismatch), the misaligned group (10 cm z axis mismatch), and the haptics-misaligned group (haptic feedback and z axis mismatch). Each subject performed the task five times, during which the grip force, time of completion, and number of faults were recorded.
  
  
  
  Compared to the subjects that performed the tasks using a properly aligned controller/arm configuration, subjects with a single-axis misalignment showed significantly more peg drops (p = 0.011) and longer time to completion (p < 0.001). Additionally, it was observed that addition of tactile feedback helps reduce the negative effects of visual-perceptual mismatch in some cases. Grip force data recorded from grasper-mounted sensors showed no difference between the different groups.
  
  
  
  The visual-perceptual mismatch created by the misalignment of the robotic controls relative to the robotic arms has a negative impact on the operator of a robotic surgical system. Introduction of other sensory information and haptic feedback systems can help in potentially reducing this effect.
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA. aabiri@ucla.edu.|UCLA Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA. aabiri@ucla.edu.
authors.forename: Ahmad
authors.identifier: 0000-0002-4709-5479
authors.initials: A
authors.lastname: Abiri
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Tao
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA.
authors.forename: Meg
authors.initials: M
authors.lastname: LaRocca
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA.
authors.forename: Xingmin
authors.initials: X
authors.lastname: Guan
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA.
authors.forename: Syed J
authors.initials: SJ
authors.lastname: Askari
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Department of Neurobiology, Los Angeles, CA, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Bisley
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Department of Surgery, Los Angeles, CA, USA.
authors.forename: Erik P
authors.initials: EP
authors.lastname: Dutson
authors.affiliation: UCLA Center for Advanced Surgical and Interventional Technology (CASIT), Los Angeles, CA, USA.|UCLA Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA.
authors.forename: Warren S
authors.initials: WS
authors.lastname: Grundfest
mesh_terms: D000328:Adult; D056228:Feedback, Sensory; D005260:Female; D013502:General Surgery / Q000379:methods*; D006801:Humans; D008297:Male; D065287:Robotic Surgical Procedures; D013647:Task Performance and Analysis; D014796:Visual Perception
keywords: Force sensor; Robotic surgery; Surgical platform; Visual–perceptual mismatch; da Vinci