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Authors Huang FC, Mussa-Ivaldi FA, Pugh CM, Patton JL
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Journal IEEE Trans Haptics Volume: 5 Issue: 4 Pages: 356-364
Publish Date 2012 10
PubMed ID 23293709
PMC ID 3535309
Abstract

To better understand how kinematic variables impact learning in surgical training, we devised an interactive environment for simulated laparoscopic maneuvers, using either 1) mechanical constraints typical of a surgical “box-trainer” or 2) virtual constraints in which free hand movements control virtual tool motion. During training, the virtual tool responded to the absolute position in space (Position-Based) or the orientation (Orientation-Based) of a hand-held sensor. Volunteers were further assigned to different sequences of target distances (Near-Far-Near or Far-Near-Far). Training with the Orientation-Based constraint enabled much lower path error and shorter movement times during training, which suggests that tool motion that simply mirrors joint motion is easier to learn. When evaluated in physically constrained (physical box-trainer) conditions, each group exhibited improved performance from training. However, Position-Based training enabled greater reductions in movement error relative to Orientation-Based (mean difference: 14.0 percent; CI: 0.7, 28.6). Furthermore, the Near-Far-Near schedule allowed a greater decrease in task time relative to the Far-Near-Far sequence (mean -13:5 percent, CI: -19:5, -7:5). Training that focused on shallow tool insertion (near targets) might promote more efficient movement strategies by emphasizing the curvature of tool motion. In addition, our findings suggest that an understanding of absolute tool position is critical to coping with mechanical interactions between the tool and trocar.

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