Force-feedback grasper helps restore sense of touch in minimally invasive surgery

The age of minimally invasive surgery has brought forth astounding changes in the health carl geld. Less pain and quicker patient recovery have been d emonstrated with several types of operations that were once performed by an open technique. With these changes have come reports of complications. The decreased sense of touch is just one of several limitations inherent to cu rrent techniques of minimally invasive surgery that limit detection of subt le or unapparent lesions on palpation, such as common duct stones and liver lesions. The purpose of this study is to demonstrate the ability of a forc e-feedback-equipped grasper to restore some of the sense of touch that is l ost in minimally invasive surgery. To demonstrate this ability, we created six silicone phantoms of identical dimensions but graded compliance, and as ked 10 subjects to place them in increasing/decreasing order of compliance. They used three tools (their dominant gloved hand, a standard laparoscopic Babcock grasper, and our force-feedback device fitted with the identical B abcock grasper) to rate the compliance of the samples in a blinded fashion. These conditions thus approximated the conditions of open surgery minimall y invasive surgery, and minimally invasive surgery fitted with a force-sens ing device, in terms of palpating tissues. Five surgeons skilled: in minima lly invasive surgery and five nonsurgeons participated in the study. The re sults indicate that the force-feedback device is significantly (P <0.05) be tter than a standard Babcock grasper at rating tissue compliance, but was n ot as successful as a gloved hand (mean of squared errors = 1.06, 3.15, and 0.25, respectively). There was no significant difference between surgeons and nonsurgeons in rating compliance. We conclude that this force-feedback instrument is able to partially restore the sense of touch in minimally inv asive surgery This restored ability may thus potentially result in more eff icient operations with improved diagnostic capabilities and fewer complicat ions during minimally invasive surgery.