000180222 001__ 180222
000180222 005__ 20190619003314.0
000180222 0247_ $$2doi$$a10.5075/epfl-thesis-5412
000180222 02470 $$2urn$$aurn:nbn:ch:bel-epfl-thesis5412-3
000180222 02471 $$2nebis$$a7326050
000180222 037__ $$aTHESIS
000180222 041__ $$aeng
000180222 088__ $$a5412
000180222 245__ $$aIncreasing Haptic Fidelity and Ergonomics in Teleoperated Surgery
000180222 269__ $$a2012
000180222 260__ $$bEPFL$$c2012$$aLausanne
000180222 300__ $$a188
000180222 336__ $$aTheses
000180222 520__ $$aOver the past few decades, surgical procedures have made  enormous progress, shifting from traditional open procedures  to less and less invasive approaches, with the promise of  smaller incisions, less complications, better cosmetic  results and shorter recovery times. With these developments  came a reduced dexterity and more complex control through the  fulcrum effect and modified eye-hand coordination. These  complications were greatly mitigated by the recent  introduction of surgical robots, allowing the surgeon to sit  in a comfortable posture, and restoring natural visuomotor  coordination. To date, the issue of the lack of haptic  feedback, which initially allowed the surgeon to intervene  without vision, identify pathological tissue, feel arteries,  etc., has not been resolved, despite the fact that it is  crucial in certain interventions. Besides, the added value of  haptic feedback is subject to controversy. Surgeons  experienced in robotic surgery have adapted to the lack of  haptic feedback and learned how to rely only on vision and  proprioceptive cues as compensation. Nevertheless, previous  studies have shown that substituting haptic information  through various sensory channels can increase surgeons'  performance. As a complete restoration of the sense of touch  is extremely challenging in minimally invasive surgery, the  advantages of haptic feedback have to be demonstrated and  quantified to justify the additional cost and complexity.  This is the aim of the present work. We hypothesized that tactile feedback as well as force is  crucial in surgery and we investigated the haptic information  involved in several representative surgical tasks. Dedicated  hardware and a virtual reality environment to simulate  suturing and palpation tasks were developed to address these  questions. Ergonomic design guidelines were established based  on an in-depth literature review and surgeons' comments  gathered in a survey. These guidelines were then used to  design and benchmark an ergonomic haptic handle featuring  active grasping feedback and additional safety features. The results of the first two studies suggest that the  benefits of haptic information highly depend on the surgical  task in question. During a suturing task, force feedback  significantly increased users' accuracy whereas torque  feedback did not result in any significant improvement. In a  palpation task, a higher recognition rate was achieved with  tactile feedback than with visual sensory substitution. The  performance of the haptic device integrating the ergonomic  handle was assessed and compared with the standard omega.7  haptic device. Results showed that the index of performance  of the original device was not degraded with the additional  hardware. The index of performance was slightly increased for  a manipulation task involving orientations. The ergonomic  assessment of the handle showed a slight decrease of the  tension in the adductor pollicis and flexor digitorium  muscles, and therefore a potential decrease of fatigue. Although just a subset of surgical tasks could be  investigated, the results indicate that haptic feedback and  sensory substitution would greatly benefit teleoperated  robotic surgery. Providing the surgeon with tactile  information can potentially restore the feeling of "contact  with the patient" and other surgeries that are highly reliant  on the sense of touch could become possible again. This  thesis presents a novel multidisciplinary approach to  systematically analyzing surgical tasks in order to improve  safety in two dimensions. Firstly, in the area of patient  safety by providing the surgeon with haptic information to  increase performance and reduce the risk of errors and  secondly, in the area of surgeon safety by providing a more  ergonomic master console. We expect this work to be a first  step in establishing a general design method for more  ergonomic surgeon consoles and trust that it will inspire  research to investigate the sensory mechanisms underlying  highly dexterous tasks such as those performed in  surgery.
000180222 6531_ $$asurgical robotics
000180222 6531_ $$ahaptics
000180222 6531_ $$aforce feedback
000180222 6531_ $$atactile feedback
000180222 6531_ $$asensory substitution
000180222 6531_ $$aergonomics
000180222 6531_ $$ahaptic device evaluation
000180222 6531_ $$achirurgie robotique
000180222 6531_ $$aretour tactile
000180222 6531_ $$aretour de force
000180222 6531_ $$asubstitution sensorielle
000180222 6531_ $$aergonomie
000180222 6531_ $$aévaluation des dispositifs haptiques
000180222 700__ $$0242146$$g183566$$aSantos Carreras, Laura
000180222 720_2 $$aBleuler, Hannes$$edir.$$g104561$$0240027
000180222 720_2 $$aGassert, Roger$$edir.$$g113795$$0240025
000180222 8564_ $$uhttps://infoscience.epfl.ch/record/180222/files/EPFL_TH5412.pdf$$zn/a$$s39463998$$yn/a
000180222 909C0 $$0252016$$pLSRO
000180222 909CO $$pthesis$$pthesis-bn2018$$pthesis-public$$pDOI$$ooai:infoscience.tind.io:180222$$qGLOBAL_SET$$pSTI$$qDOI2
000180222 917Z8 $$x108898
000180222 917Z8 $$x108898
000180222 918__ $$dEDPR$$cIMT$$aSTI
000180222 919__ $$aLSRO1
000180222 920__ $$b2012
000180222 970__ $$a5412/THESES
000180222 973__ $$sPUBLISHED$$aEPFL
000180222 980__ $$aTHESIS