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Salient haptic skills trainer: initial validation of a novel simulator for training force-based laparoscopic surgical skills

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Abstract

Background

There is an increasing need for efficient training simulators to teach advanced laparoscopic skills beyond those imparted by a box trainer. In particular, force-based or haptic skills must be addressed in simulators, especially because a large percentage of surgical errors are caused by the over-application of force. In this work, the efficacy of a novel, salient haptic skills simulator is tested as a training tool for force-based laparoscopic skills.

Methods

Thirty novices with no previous laparoscopic experience trained on the simulator using a pre-test–feedback–post-test experiment model. Ten participants were randomly assigned to each of the three salient haptic skills—grasping, probing, and sweeping—on the simulator. Performance was assessed by comparing force performance metrics before and after training on the simulator.

Results

Data analysis indicated that absolute error decreased significantly for all three salient skills after training. Participants also generally decreased applied forces after training, especially at lower force levels. Overall, standard deviations also decreased after training, suggesting that participants improved their variability of applied forces.

Conclusions

The novel, salient haptic skills simulator improved the precision and accuracy of participants when applying forces with the simulator. These results suggest that the simulator may be a viable tool for laparoscopic force skill training. However, further work must be undertaken to establish full validity. Nevertheless, this work presents important results toward addressing simulator-based force-skills training specifically and surgical skills training in general.

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Acknowledgments

The authors thank Giovannina Arcese for her assistance in collecting data, and also acknowledge the contribution of Varun Prabhu, Ryan Bontreger, Billy Few, and Pallavi Srikanth in designing and refining the haptic simulator.

Disclosures

Authors R. Singapogu, S. DuBose, L. Long, D. Smith, T. Burg, C. Pagano, and K. Burg have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Institute for Biological Interfaces of Engineering, Clemson University, 401 Rhodes, Clemson, SC, 29634, USA

    Ravikiran B. Singapogu, Dane E. Smith, Timothy C. Burg, Christopher C. Pagano & Karen J. L. Burg

  2. Department of Bioengineering, Clemson University, Clemson, SC, USA

    Ravikiran B. Singapogu, Dane E. Smith & Karen J. L. Burg

  3. Greenville Hospital System University Medical Center, Greenville, SC, USA

    Dane E. Smith

  4. Department of Psychology, Clemson University, Clemson, SC, USA

    Sarah DuBose, Lindsay O. Long & Christopher C. Pagano

  5. Department of Electrical and Computer Engineering, Clemson University, Clemson, SC, USA

    Timothy C. Burg & Karen J. L. Burg

Authors
  1. Ravikiran B. Singapogu
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  2. Sarah DuBose
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  3. Lindsay O. Long
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  4. Dane E. Smith
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  5. Timothy C. Burg
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  6. Christopher C. Pagano
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  7. Karen J. L. Burg
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Corresponding author

Correspondence to Ravikiran B. Singapogu.

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Singapogu, R.B., DuBose, S., Long, L.O. et al. Salient haptic skills trainer: initial validation of a novel simulator for training force-based laparoscopic surgical skills. Surg Endosc 27, 1653–1661 (2013). https://doi.org/10.1007/s00464-012-2648-y

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  • DOI: https://doi.org/10.1007/s00464-012-2648-y

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