Abstract
Background: Due to the limited force feedback provided by laparoscopic instruments, surgeons may have difficulty in applying the appropriate force on the tissue. The aim of this study was to determine the influence of force feedback and visual feedback on the exerted pinch force.
Methods: A grasper with a force sensor in the jaws was developed. Subjects with and without laparoscopic experience grasped and pulled pig bowel with a force of 5 N. The applied pinch force was measured during tasks of 1-s and 1-min duration. Visual feedback was provided in half the measurements. Force feedback was adjusted by changing the mechanical efficiency of the forceps from 30% to 90%.
Results: The mean pinch force applied was 6.8 N (± 0.5), whereas the force to prevent slippage was 3.0 N ( ± 0.4). Improving the mechanical efficiency had no effect on the pinch force for the 1-s measurements. The amount of excessive pinch force when holding tissue for 1 min was lower at 30% mechanical efficiency compared with 90% (105% vs 131 %, p = 0.04). The tissue slipped more often when the subject had no visual feedback (2% vs 8%, p = 0.02).
Conclusion: Force feedback and visual feedbacK playa more limited role than expected in the task of gras** tissue with laparoscopic forceps.
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References
Balázs M, Feussner H, Hirzinger G, Omote K, Ungeheuer A (1998) A new tool for minor-access surgery: replacing mechanical joints in laparoscopic forceps with elastic beams for improved pressure control and sensitivity. IEEE Eng Med Biol 17: 45–48
Bholat OS, Haluck RS, Murray WB, Gorman PJ, Krummel TM (1999) Tactile feedback is present during minimally invasive surgery. J Am Coli Surg 189: 349–355
den Boer KT, Herder JL, Sjoerdsma W, Meijer DW, Gouma DJ, Stassen HG (1999) Sensitivity of laparoscopic dissectors: what can you feel? Surg Endosc 13: 869–873
de Visser H (2003) Gras** safely, instruments for bowel manipulation investigated [Dissertation]. Delft University of Technology, Delft, The Netherlands
de Visser H, Heijnsdijk EAM, Herder JL, Pistecky PV (2002) Forces and displacements in colon surgery. Surg Endosc 16: 142–1430
Heijnsdijk EAM, Dankelman J, Gouma DJ (2002) Effectiveness of gras** and duration of clam** using laparoscopic graspers. Surg Endosc 16: 1329–1331
Herder JL, Horward MJ, Sjoerdsma W (1997) A laparoscopic grasper with force perception. Min Invas Ther Allied Technol 6: 279–286
Howe RD, Peine WJ, Kontarinis DA, Son JS (1995) Remote palpation technology. IEEE Eng Med Biol 14: 318–323
Joice P, Hanna GB, Cuschieri A (1998) Errors enacted during endoscopic surgery—a human reliability analysis. Appl Erg 29: 409–414
Rosen J, Hannaford B, MacFarlane MP, Sinanan MN (1999) Force controlled and teleoperated endoscopic grasper for minimally invasive surgery—experimental performance evaluation. IEEE Trans Biomed Eng 46: 1212–1221
Ruurda JP, van Vroonhoven TJMV, Breeders TAMJ (2002) Robot-assisted surgical systems: a new era in laparoscopic surgery. Ann R Coli Surg Engl 84: 223–226
Sjoerdsma W, Herder JL, Horward MJ, Jansen A, Bannenberg JJG, Grimbergen CA (1997) Force transmission of laparoscopic gras** instruments. Min Invas Ther Allied Technol 6: 274–278
van der Piji AJ, Herder JL (2001) Development of 5-mm trocar laparoscopic forceps with mechanical force feedback. Proceedings of the Design Engineering Technical Conferences 2001, American Society of Mechanical Engineers, 3–12 September 2001, DETC 01, ASME Conference, Pittsburgh PA, USA
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Heijnsdijk, E.A.M., Pasdeloup, A., van der Pijl, A.J. et al. The influence of force feedback and visual feedback in gras** tissue laparoscopicaUy. Surg Endosc 18, 980–985 (2004). https://doi.org/10.1007/s00464-003-9244-0
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DOI: https://doi.org/10.1007/s00464-003-9244-0