Determining the contribution of visual and haptic cues during compliance discrimination in the context of minimally invasive surgery

Abstract

While minimally invasive surgery is replacing open surgery in an increasing number of surgical procedures, it still poses risks such as unintended tissue damage due to reduced visual and haptic feedback. Surgeons assess tissue health by analysing mechanical properties such as compliance. The literature shows that while both types of feedback contribute to the final percept, visual information is dominant during compliance discrimination tasks. The magnitude of that contribution, however, was never quantitatively determined. To determine the effect of the type of visual feedback on compliance discrimination, a psychophysical experiment was set up using different combinations of direct and indirect visual and haptic cues. Results reiterated the significance of visual information and suggested a visio-haptic cross-modal integration. Consequently, to determine which cues contributed most to visual feedback, the impact of force and position on the ability to discriminate compliance using visual information only was assessed. Results showed that isolating force and position cues during indentation enhanced performance. Furthermore, under force and position constraints, visual information was shown to be sufficient to determine the compliance of deformable objects. A pseudo-haptic feedback system was developed to quantitatively determine the contribution of visual feedback during compliance discrimination. A psychophysical experiment showed that the system realistically simulated viscoelastic behaviour of compliant objects. Through a magnitude estimation experiment, the pseudo-haptic system was shown to be successful at generating haptic sensations of compliance during stimuli indentation only by modifying the visual feedback presented to participants. This can be implemented in research and educational facilities where advanced force feedback devices are inaccessible. Moreover, it can be incorporated into virtual reality simulators to enhance force ranges. Future work will assess the value of visual cue augmentation in more complicated surgical tasks.