An experimental study about haptic feedback in robotic surgery: may visual feedback substitute tactile feedback?

The aim of this study is to demonstrate the hypothesis that the experience of the surgeon is sufficient to partially compensate for the lack of haptic feedback of the robotic system da Vinci Si HD (Intuitive®). Twenty-five international surgeons belonging to different areas of surgical specialization were divided into two groups of investigation: experts and non-experts in the use of da Vinci Platform. This allocation was made on the basis of the following criteria: the number of performed procedures, the number of robotic working days and the number of true console hours. All participants underwent a specific test to assess their ability to recognize the thickness of custom-made membranes, without the availability of haptic feedback. After the performance of the surgeons, score was given according to an appropriate evaluation system (time, preciseness, force of tension and finding a metallic object). The analysis of the performances of participants provided the following results: an average score of 8.87 for the experts compared to 3.57 of non-experts with significant difference (P < 0.05). Other parameters of interest as the average time to conduct the test showed a result of 28.8 s for experts and 71.3 s of non-experts. After our results, a significant difference between the two groups in terms of performance was found. Our hypothesis that the expertise ability of the experts might partially overcome the lack of haptic feedback was confirmed. Probably visual feedback may play a role.