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J Thorac Cardiovasc Surg 2005;129:151-158
© 2005 The American Association for Thoracic Surgery

Evolving Technology

Effect of sensory substitution on suture-manipulation forces for robotic surgical systems

^a Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Md, USA
^b Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Md, USA

Received for publication October 27, 2003; revisions received February 8, 2004; accepted for publication May 20, 2004.

^* Address for reprints: David D. Yuh, MD, Division of Cardiac Surgery, The Johns Hopkins Hospital, 600 North Wolfe St, Blalock 618, Baltimore, MD 21287-4618 (E-mail: dyuh{at}csurg.jhmi.jhu.edu).

OBJECTIVES: Direct haptic (force or tactile) feedback is not yet available in commercial robotic surgical systems. Previous work by our group and others suggests that haptic feedback might significantly enhance the execution of surgical tasks requiring fine suture manipulation, specifically those encountered in cardiothoracic surgery. We studied the effects of substituting direct haptic feedback with visual and auditory cues to provide the operating surgeon with a representation of the forces he or she is applying with robotic telemanipulators.

METHODS: Using the robotic da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, Calif), we compared applied forces during a standardized surgical knot-tying task under 4 different sensory-substitution scenarios: no feedback, auditory feedback, visual feedback, and combined auditory-visual feedback.

RESULTS: The forces applied with these sensory-substitution modes more closely approximate suture tensions achieved under ideal haptic conditions (ie, hand ties) than forces applied without such sensory feedback. The consistency of applied forces during robot-assisted suture tying aided by visual feedback or combined auditory-visual feedback sensory substitution is superior to that achieved with hand ties. Robot-assisted ties aided with auditory feedback revealed levels of consistency that were generally equivalent or superior to those attained with hand ties. Visual feedback and auditory feedback improve the consistency of robotically applied forces.

CONCLUSIONS: Sensory substitution, in the form of visual feedback, auditory feedback, or both, confers quantifiable advantages in applied force accuracy and consistency during the performance of a simple surgical task.

This article has been cited by other articles:

				C. E. Reiley, T. Akinbiyi, D. Burschka, D. C. Chang, A. M. Okamura, and D. D. Yuh Effects of visual force feedback on robot-assisted surgical task performance J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 196 - 202. [Abstract] [Full Text] [PDF]