Effects of haptic and graphical force feedback on teleoperated palpation

Direct haptic feedback and graphical force feedback have both been hypothesized to improve the performance of robot-assisted surgery. In this study we evaluate the benefits of haptic and graphical force feedback on surgeon performance and tissue exploration behavior during a teleoperated palpation task of artificial tissues. Seven surgeon subjects (four experienced in robot-assisted surgery) used a 7-degree-of-freedom teleoperated surgical robot to identify a comparatively rigid rigid target object (representing a calcified artery) in phantom heart models using the following feedback conditions: (1) direct haptic and graphical feedback, (2) direct haptic only, (3) graphical feedback only, and (4) no feedback. To avoid the problems of force sensing in a minimally invasive surgical environment, we use a position-exchange controller with dynamics compensation for direct haptic feedback and a force estimator displayed via tool-tip tracking bar graph for graphical force feedback. Although the transparency of the system is limited with this approach, results show that direct haptic force feedback minimizes applied forces to the tissue, while coupled haptic and graphical force feedback minimizes subject task error. For experienced surgeons, haptic force feedback substantially reduced task error independent of graphical feedback.