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. 2010 Dec;24(12):3102-8.
doi: 10.1007/s00464-010-1096-9. Epub 2010 May 13.

Force measurement platform for training and assessment of laparoscopic skills

Tim Horeman  1 , Sharon P Rodrigues, Frank-Willem Jansen, Jenny Dankelman, John J van den Dobbelsteen
Affiliations

Force measurement platform for training and assessment of laparoscopic skills

Tim Horeman et al. Surg Endosc. 2010 Dec.

Abstract

Background: To improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual-reality (VR) trainers. Current training is mainly focused on hand-eye coordination. Training methods that focus on applying the right amount of force are not yet available.

Methods: The aim of this project is to develop a system to measure forces and torques during laparoscopic training tasks as well as the development of force parameters that assess tissue manipulation tasks. The force and torque measurement range of the developed force platform are 0-4 N and 1 Nm (torque), respectively. To show the potential of the developed force platform, a pilot study was conducted in which five surgeons experienced in intracorporeal suturing and five novices performed a suture task in a box trainer.

Results: During the pilot study, the maximum and mean absolute nonzero force that the novice used were 4.7 N (SD 1.3 N) and 2.1 N (SD 0.6 N), respectively. With a maximum force of 2.6 N (SD 0.4 N) and mean nonzero force of 0.9 N (SD 0.3 N), the force exerted by the experts was significantly lower.

Conclusions: The designed platform is easy to build, affordable, and accurate and sensitive enough to reflect the most important differences in, e.g., maximal force, mean force, and standard deviation. Furthermore, the compact design makes it possible to use the force platform in most box trainers.

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Figures

Fig. 1
Fig. 1
Schematic exploded view of the SpaceNavigator (adapted from patent EP1850210)
Fig. 2
Fig. 2
Left: force platform built from mechanical components. Right: modified SpaceNavigator that is fixed between base plate and table
Fig. 3
Fig. 3
Vector representation of example nonselective manipulation
Fig. 4
Fig. 4
Direction of applied force and torque during testing
Fig. 5
Fig. 5
Left: force platform with artificial skin tissue. Right: test setup with box trainer, trocars, laparoscope, needle holders, and force platform
Fig. 6
Fig. 6
Mean ± standard deviation (SD) sensor output in arbitrary units and regression lines for a positive force and torque range
Fig. 7
Fig. 7
Mean ± standard deviation (SD) sensor output during test run 1–3. Q1 to Q8 represent the direction vectors of the applied force and torque as described in the “Materials and methods” section
Fig. 8
Fig. 8
Observed difference in needle driving between expert (A) and novice (B). R is rotation around needle centre point, X is translation parallel to X-axis, Y is translation parallel to Y-axis
Fig. 9
Fig. 9
A Absolute force exerted on artificial tissue. B Three-dimensional representation of force exerted on artificial tissue
Fig. 10
Fig. 10
Differences between experts and novices in performance. Each data point represents the averaged value over two measurements of one subject
Fig. 11
Fig. 11
Force graphs of a novice and surgeon who performed the needle-driving task four times
Fig. 12
Fig. 12
Schematic diagram of a resident during training on box trainer equipped with a force platform
See this image and copyright information in PMC

References

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