Comparison of Force Matching Performance in Conventional and Laparoscopic Force-Based Task
01 Sep 2014-Vol. 58, Iss: 1, pp 683-687
TL;DR: The force perception of 18 novices in the absence of external information is analyzed by comparing the isometric force matching performance of index finger in extended arm posture with that of laparoscopic instrument in a force-based probing task and the effect of handedness on force perception is examined.
Abstract: Laparoscopic instruments have limited haptics feedback. Hence, novices tend to exert excessive force which leads to tissue trauma. In laparoscopic surgery, no external information is available on the magnitude of excessive force. Therefore, novices should be trained to accurately perceive their own force output. This study analyzed the force perception of 18 novices in the absence of external information, by comparing the isometric force matching performance of index finger (i.e. used in conventional procedures) in extended arm posture with that of laparoscopic instrument in a force-based probing task. The study also examined the effect of handedness on force perception. A contra-lateral force matching paradigm was employed to analyze the matching performance of the novice subjects. Interestingly, matching error was found to be lower for laparoscopic instrument. An effect of handedness was visible for laparoscopic instrument only. The dominant hand overestimated the forces of non-dominant hand. The result...
Citations
More filters
TL;DR: Modern day curriculum-based training should evaluate the skills of residents with robust force and psychomotor-based exercises for proficient laparoscopy and visual feedback on force and motion during training has the potential to enhance the learning curve of residents.
28 citations
TL;DR: Competency-based laparoscopic skills assessment curriculum should be updated to meet the requirements of bimanual force-based training.
Abstract: Background. The purpose of this study was to examine the face and construct validity of a custom-developed bimanual laparoscopic force-skills trainer with haptics feedback. The study also examined ...
8 citations
TL;DR: It is revealed that the absolute error, constant error, and MVIC decreased as the wrist joint angle deviated from the neutral position, in contrast to most previous studies.
4 citations
TL;DR: Results indicated that females exerted approximately 73.6% (100.6 N) of the strength exerted by males, and the relationship between the actual and perceived force of exertion displayed a nonlinear S-shaped curve.
Abstract: Measurement of thumb force in the industrial filed is important to quantify the risk of manual tasks. However, few studies have assessed the thumb force. Therefore, the purpose of this study was to investigate the relationship between actual thumb force and perceived force according to the force levels and gender. A total of 31 healthy participants (23 males and 8 females) were asked to exert a maximum thumb force (MTF) and random levels of target thumb force (10, 30, 50, 70, and 90% MTF). Results indicated that females exerted approximately 73.6% (100.6 N) of the strength exerted by males (136.7 N). Based on the differences between actual and perceived thumb exertions, the highest accuracy was achieved at 50% MTF, designated as “50%-phenomenon”. At 10% and 30% MTF levels, participants tended to exert greater strength (over-exertion) than the perceived exertions, whereas participants showed less strength (under-exertion) than the perceived exertions at 70% and 90% MTFs. Participants generally exerted greater and lesser thumb force than the perceived exertions at levels lower and higher than 50% MTF, respectively. Thus, the relationship between the actual and perceived force of exertion displayed a nonlinear S-shaped curve.
1 citations
Cites background from "Comparison of Force Matching Perfor..."
...Kong et al. [11] and Prasad and Manivannan [12] reported that the perception of handgrip force differed according to the handedness....
[...]
...[11] and Prasad and Manivannan [12] reported that the perception of handgrip force differed according to the handedness....
[...]
31 Oct 2017
TL;DR: This study analyzes the impedance skills of residents and surgeons using custom developed novel bimanual laparoscopic skills trainer to explore the effects of experience on impedance based training.
Abstract: Laparoscopic surgery has widely replaced open surgery due to the advantages it has for patients both during surgery and post-surgery recovery. Due to inversion and remote access to the surgical site, haptics feedback is altered with laparoscopic surgical instruments [1]. This leads to excessive exertion of force [2]. Many intra operative errors like tissue injury in laparoscopic surgery are due to texertion of large forces [2]. Over the years, virtual reality (VR) based laparoscopic surgical simulators with haptics feedback have been instrumental in teaching basic and advanced laparoscopic skills to residents and surgeons [3]. However, a major limitation in modern day VR based simulator training systems is that they do not effectively teach the bimanual impedance-based laparoscopic skills. Past studies on VR based laparoscopic training have captured the skills sets of residents and surgeons using force and psychomotor metrics [3,4]. However, till date none have explored the effects of experience on impedance based training. In this study, we analyze the impedance skills of residents and surgeons using custom developed novel bimanual laparoscopic skills trainer.
Cites background from "Comparison of Force Matching Perfor..."
...Many intra operative errors like tissue injury in laparoscopic surgery are due to texertion of large forces [2]....
[...]
...This leads to excessive exertion of force [2]....
[...]
References
More filters
TL;DR: An inventory of 20 items with a set of instructions and response- and computational-conventions is proposed and the results obtained from a young adult population numbering some 1100 individuals are reported.
33,268 citations
"Comparison of Force Matching Perfor..." refers background in this paper
...10 subjects were right-handed and 8 were lefthanded (Oldfield, 1971)....
[...]
TL;DR: It is shown that there are only a few points within laparoscopic cholecystectomy where the complication-causing errors occur, which suggests that focused training to heighten vigilance might be able to decrease the incidence of bile duct injury.
Abstract: Bile duct injuries are the main serious technical complication of laparoscopic cholecystectomy. 1,2 Data are insufficient to determine precisely the frequency of bile duct injuries, but a reasonable estimate is one in 1,000 cases. 2 A decade ago, as the technique of laparoscopic cholecystectomy was first being learned by otherwise fully trained, practicing surgeons, the injury rate was noted to be greater during an individual’s first dozen cases than in subsequent ones. 2 This learning curve contribution is now much less important, for surgical residents learn the procedure under direct supervision of more experienced surgeons.
Surgeons have always analyzed their technical complications for insights that might be translated into improved performance. In the past the information available from such reviews could rarely go much beyond a tabulation of results. An understanding of the root causes of technical complications remained elusive. This report takes analysis of technical complications to greater depths, for it integrates the findings of videotapes of operations involving bile duct injuries, operative notes dictated after the operation had been completed but before an injury had become apparent, and conceptual tools of human factors research and the cognitive science of human error.
715 citations
"Comparison of Force Matching Perfor..." refers background in this paper
...Many intra-operative errors in LS are due to the exertion of large forces (Joice, Hanna, & Cuschieri, 1998; Tang, Hanna, & Cuschieri, 2005; Way et al., 2003)....
[...]
TL;DR: It is shown that, in tit-for-tat exchanges between two children, both sides are reporting their true percept and that the escalation is a natural by-product of physical conflicts.
Abstract: Physical conflicts tend to escalate. For example, as tit-for-tat exchanges between two children escalate, both will often assert that the other hit him or her harder. Here we show that, in such situations, both sides are reporting their true percept and that the escalation is a natural by-product of
369 citations
"Comparison of Force Matching Perfor..." refers result in this paper
...in agreement with the finger force perception study (Park et al., 2008; Shergill et al., 2003)....
[...]
...This observation is in agreement with the finger force perception study (Park et al., 2008; Shergill et al., 2003)....
[...]
TL;DR: Objective evidence of a difference in laparoscopic skills between surgeons differing gender, hand dominance, and computer experience is provided, which may influence the future development of training program for Laparoscopic surgery.
Abstract: Background: The impact of gender and hand dominance on operative performance may be a subject of prejudice among surgeons, reportedly leading to discrimination and lack of professional promotion. However, very little objective evidence is available yet on the matter. This study was conducted to identify factors that influence surgeons’ performance, as measured by a virtual reality computer simulator for laparoscopic surgery. Methods: This study included 25 surgical residents who had limited experience with laparoscopic surgery, having performed fewer than 10 laparoscopic cholecystectomies. The participants were registered according to their gender, hand dominance, and experience with computer games. All of the participants performed 10 repetitions of the six tasks on the Minimally Invasive Surgical Trainer—Virtual Reality (MIST-VR) within 1 month. Assessment of laparoscopic skills was based on three parameters measured by the simulator: time, errors, and economy of hand movement. Results: Differences in performance existed between the compared groups. Men completed the tasks in less time than women (p = 0.01, Mann–Whitney test), but there was no statistical difference between the genders in the number of errors and unnecessary movements. Individuals with right hand dominance performed fewer unnecessary movements (p = 0.045, Mann–Whitney test), and there was a trend toward better results in terms of time and errors among the residence with right hand dominance than among those with left dominance. Users of computer games made fewer errors than nonusers (p = 0.035, Mann–Whitney test). Conclusions: The study provides objective evidence of a difference in laparoscopic skills between surgeons differing gender, hand dominance, and computer experience. These results may influence the future development of training program for laparoscopic surgery. They also pose a challenge to individuals responsible for the selection and training of the residents.
246 citations
TL;DR: This study confirmed the applicability and usefulness of an observational methodology in the assessment of human error in endoscopic surgical performance in order to identify underlying performance shaping factors (PSFs) and so reduce error rates.
228 citations