Shifts in force perception threshold in laparoscopic surgery with experience

In laparoscopic surgery, the surgeon receives limited haptic feedback and relies on visual feedback to judge the amount of force applied to tissues. It has been shown that friction forces inherent in the instrumentation increased the haptic perception threshold of naïve subjects. A controlled experiment was conducted to examine the effects of experience on force perception threshold in a simulated tissue-probing task. Fourteen subjects participated in a mixed design experiment, with friction, vision, and tissue softness as independent within-subjects factors, experience as an independent between-subjects factor, and applied force and detection time as dependent measures. Higher thresholds and longer detection times were observed when friction was present. Experienced surgeons applied a greater force than novices, but were quicker to detect contact with tissue, suggesting that experience allowed surgeons to perform more efficiently while keeping within the limits of safety.