Laparoscopic Training Instrument Allows Surgeon to Feel Grasp Force

A prototype keyhole surgery-training system sends tangible feedback signals to a handle held by the surgeon, giving him a better feeling of how hard he is grasping the tissue with the operating instruments.

Developed at the Delft University of Technology (The Netherlands), the laparoscopic grasp trainer gives the surgeon augmented tangible feedback on the amount of grasp force being applied, via sensors in the tip of the instrument that measure how hard he (or she) is grasping. This information is fed back to the handle, which contains a cylinder that can turn in relation to the hand--as if something is falling out of the hand. In this way, the cylinder indicates that the surgeon is grasping too gently. The handle also contains vibrating elements, which vibrate if the surgeon is grasping too hard, while also taking account of how hard the surgeon is pulling. The harder they pull on the tissue, the less hard they should grasp.


"Experiments have shown that augmented feedback on the grasp force is a good way for surgeons of all levels to gain a better command of gauging laparoscopic grasp force,” said laparoscopic grasp trainer developer Eleonora Westebring-van der Putten, PhD. "By training with feedback, surgeons learn to control their laparoscopic grasp force more quickly. When the feedback signal is removed, the surgeons can still carry out the procedure with reduced force. The feedback therefore helps with the control of the laparoscopic grasp force, even if it is only used in training.”

In the case of direct tissue contact with bare hands (as in open surgery), the surgeon can feel the temperature, shape, structure, and consistency of the tissue touched, as well as feel directly how much force is applied, or whether the tissue slips through the fingers or not. The surgeon can thus adjust the operation force according to this natural haptic feedback. In laparoscopy, the tissue is manipulated by instruments and not by bare hands, interfering with the natural sensory perception of the surgeon that is needed to manipulate the tissue safely.

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Delft University of Technology