Surgical robots and other training tools in minimally invasive surgery

Minimally invasive surgery (MIS) is an operating technique using long instruments inserted via small incisions in the skin. Because of the interposition of these instruments, haptic feedback is limited to force feedback to the human hand. Extensive training is needed to master this difficult surgical method. Traditionally, surgical training is obtained in the OR under suspension of an experienced surgeon. Several training methods are becoming available to train minimally invasive surgical skills outside the operating room, e.g. Pelvi-trainers (a box in which instruments can be inserted), VR-trainers, with and without a haptic feedback, and robotic systems have been proposed. For an effective (having the desired effect) and efficient (quick and cheap) method of training, it is necessary to adapt training to different levels of behaviour, having their own objectives, means and needs. In this paper the advantages and disadvantages of the different training methods would be compared. Furthermore, the role of force feedback would be discussed and suggestions to motivate the use of these systems would be given.