Abstract
Purpose: Vitreoretinal surgery involves the manipulation of delicate retinal membranes with a required surgical accuracy often on the order of tens of microns, a scale at or near the limit of human positional ability. In addition, forces imposed by the tissue on the surgical cool are exceedingly small. Here we investigate the magnitude of forces generated during retinal surgery in cadaveric porcine eyes and compare the results with the magnitude of forces discernable by retinal surgeons. This data will be used as a design guideline for robotic surgical augmentation systems currently under development Methods: The study was performed in two phases. First, retinal surgeons manipulated the retina of porcine cadaver eyes with a calibrated 1-axis force sensing retinal pick while data was simultaneously recorded. In the second phase, blindfolded subjects held the pick and were instructed to press a button whenever an “event” was felt. Events were generated by slowly tapping the end of the pick with varying force while both the magnitudes of forces applied and the responses of the subjects we recorded. The magnitudes of forces generated during retinal surgery were then compared with those that could be discerned by the subjects. Results: Roughly 75% of all forces measured during retinal microsurgery were found to be less than 7.5 mN in magnitude, however only 19.3 ± 8.1% (N=492) of events generated at this level could be felt by the subjects. Conclusions: The results of this study indicate that a majority of retinal surgery is probably performed without the surgeon being able to “feel” interactions between retinal tissue and the surgical tool. Prior studies have indicated that relying on visual feedback alone increases the length of manual manipulation tasks and reduces task accuracy. The lack of tactile sensation during retinal surgery similarly could adversely affect surgical outcome.
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© 1999 Springer-Verlag Berlin Heidelberg
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Gupta, P.K., Jensen, P.S., de Juan, E. (1999). Surgical Forces and Tactile Perception During Retinal Microsurgery. In: Taylor, C., Colchester, A. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI’99. MICCAI 1999. Lecture Notes in Computer Science, vol 1679. Springer, Berlin, Heidelberg. https://doi.org/10.1007/10704282_132
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DOI: https://doi.org/10.1007/10704282_132
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