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. 2024 Aug;38(8):4222-4228.
doi: 10.1007/s00464-024-10877-w. Epub 2024 Jun 10.

Feeling of pulsations in artificial arteries with a real time haptic feedback laparoscopic grasper: a validation study

Michel P H Vleugels  1   2 , Masie Rahimi  3   4   5
Affiliations

Feeling of pulsations in artificial arteries with a real time haptic feedback laparoscopic grasper: a validation study

Michel P H Vleugels et al. Surg Endosc. 2024 Aug.

Abstract

Introduction: Despite the advancements in technology and organized training for surgeons in laparoscopic surgery, the persistent challenge of not being able to feel the resistance and characteristics of the tissue, including pulsations, remains unmet. A recently developed grasper (Optigrip®) with real time haptic feedback, based on photonic technology, aims to address this issue by restoring the tactile sensation for surgeons. The key question is whether pulsations can be detected and at what minimal size level they become clinical significant.

Methods: To simulate arterial conditions during laparoscopic procedures, four different silicone tubes were created, representing the most prevalent arteries. These tubes were connected to a validated pressure system, generating a natural pulse ranging between 80 and 120 mm Hg. One control tube without pressure was added. The surgeons had to grasp these tubes blindly with the conventional grasper or the haptic feedback grasper in a randomized order. They then indicated whether they felt the pressure or not and the percentage of correct answers was calculated.

Results: The haptic grasper successfully detected 96% of all pulsations, while the conventional grasper could only detect 6%. When considering the size of the arteries, the Optigrip® identified pulsations in 100% the 4 and 5 mm arteries and 92% of the smallest arteries. The conventional grasper was only able to feel the smallest arteries in 8%. These differences were highly significant (p < 0.0001).

Conclusion: This study demonstrated that the newly developed haptic feedback grasper enables detection of arterial pulsations during laparoscopy, filling an important absence in tactile perception within laparoscopic surgery.

Keywords: Arterial pulsations; Laparoscopic surgery; Realtime haptic feedback.

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Conflict of interest statement

Dr. Michel P. H. Vleugels is the inventor and patent holder of this technology. Dr. A. Masie Rahimi has no conflict of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
The Optigrip grasper
Fig. 2
Fig. 2
Pulse difference related to vessel type [20]
Fig. 3
Fig. 3
Diameter and wall thickness of vessels [21]
Fig. 4
Fig. 4
Linear relation between force and pulsation in all four artificial blood vessels
Fig. 5
Fig. 5
a Pump and four prepared tubes. b Black box trainer with the 5 tubes inside
Fig. 6
Fig. 6
Percentage of correct answers for only pulsating tubes
Fig. 7
Fig. 7
Correct answers according tubes
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