Exploring laparoscopic surgery training with Cable-driven ARm EXoskeleton (CAREX-M)

Laparoscopic surgery is a challenging task for surgeons. The challenges include: (i) lack of depth perception, (ii) inverted motion of the hand instrument. In this paper, we investigate the possibility of using CAREX-M, a Cable-driven Arm Exoskeleton - Mobile, to train subjects using laparoscopic tool to do a simple task. CAREX-M uses an assist-as-needed controller that generates assistive force that helps the subjects to move the laparoscopic tool along a prescribed trajectory. An experiment was conducted which trains the subjects to use the laparascopic tool to follow a straight path. Two groups of subjects (experiment and control) participated in the experiment. The experiment group received assistance from CAREX-M during the training, while the control group did not receive any assistance. The results show that the experiment group gained significantly larger performance improvement from training than the control group. This shows that CAREX-M is effective in training of laparascopic tool manipulation. A further analysis shows that the improvement in the performance comes from the reduced error along the depth direction. This suggests that CAREX-M can improve the depth perception of the subjects.