The global health crisis has accelerated the use of haptic technology, enabling surgeons to continue their training under strict Covid restrictions. However, as with all emerging technologies, I noticed a hype circle. I hope I can clarify some of the misunderstandings and explain the practical value of this technique in surgical training.
The term “tactile” has been downplayed and manipulated to meet the marketing requirements of certain vendors. Among the five known senses, touch is undoubtedly the most proficient. It is the only one that can provide input and output at the same time. Haptics has been in development for some time to integrate tactile feedback into computer simulations to provide tactile and proprioceptive feedback.
Surgery is a multi-sensory skill. Touch is essential to enable the surgeon to learn and perform surgery. Tactile exploration provides surgeons with information beyond visual cues, allowing movement to be adjusted during surgery. Pressure and contour provide information about the shape of the object. During surgery with limited or non-existent vision, the sense of touch is essential to guide the surgeon’s actions. For example, in ophthalmology, cataract surgery requires precise accuracy. The blood vessels are very fragile and can withstand much less force than ligaments.
Surgical education is a lifelong learning that requires extensive practice on patients under the close supervision of teachers. This may become cost-effective for teaching and impossible in a pandemic. The ability to conduct cadaver labs and face-to-face meetings with students and sales teams is impossible.
Therefore, cadavers or animals are trained in surgery. However, there are moral and technical flaws. For example, the shelf life of dead bodies is very short. The embalmed corpses lacked the texture and tactile feedback needed to practice procedures such as nerve blockers. Although the training of real patients is imperative, it brings risks to living patients. In addition, the cost of the cadaver laboratory is high.
Open a feeling, the virtual world
This is where haptics comes in as an important training alternative, because it allows surgeons to interact with the virtual environment by adding haptics to the overall simulation. Therefore, it is not surprising that the global haptic technology market is expected to be impacted. Reach USD 4.5 billion by 2026Analysts said that part of the reason is its growth in the medical industry.
However, the problem is that the term “tactile” is being played down as the market’s attractiveness increases. In the broadest sense, touch can be a system that combines tactile feedback and vibrates through touch.
Haptics is the deployment of vibration and/or physical resistance when using technology to attract your sense of touch. The simplest example is when your smartphone vibrates in your pocket when you make a call. However, it must be noted that not all tactile sensations are the same.
Tactile interaction is understood as the two-way transmission of skin and motor sensations. Skin sensation refers to pressure, breakage, and blockage caused by structural strains and vibrations applied to the skin. Kinesthesia includes the force and movement sensed by muscles, tendons, and joints. In active skin sensation, users usually explore the touchable surface with their fingertips. In kinesthetic haptics, users consciously apply force and movement to haptic devices to collect information.
For example, during knee replacement surgery, surgeons use surgical saws to remove bones. Tactile feedback enables the surgeon to truly “feel” the change in resistance between the harder and softer bones to prevent damage to blood vessels, nerves, etc. These bone layers are invisible and must be bypassed by feeling.
Flight simulator-style haptic technology for surgery has been around for some time. But they are fixed room systems and very expensive, approximately 0.5% of surgeons can use them. There are now very affordable portable systems that have shown their value during the pandemic.
Some companies provide low-cost, scalable software-as-a-service platforms to provide simulation experiences for life science companies, educational institutions, and qualified surgeons. The solution consists of immersive kinesthetic tactile technology and off-the-shelf hardware. These solutions include an intelligent engine that has been programmed to simulate the real feel of many medical tools and tissue, muscle and bone variants. When surgeons use it, they will feel the actual surgical procedure within sub-millimeter precision and resistance.
One size is not suitable for everyone
When we finally return to the “new normal” and COVID-19 restrictions are relaxed, there will be a large backlog of exams and elective procedures, which will further reduce training opportunities for students and experienced surgeons who want to improve their skills.
Tactile technology will become priceless here. By providing affordable realistic simulations for every surgical student, surgeon, educational institution, and life science company in a safe environment, Haptics has the potential to democratize surgical training.
With our progress, haptic technology has the ability to improve the cognitive and psychomotor abilities of surgeons, and ultimately improve the treatment effect of patients. But first, the confusion and frustration about what touch is and what it can achieve must be eliminated.
Touch is not a panacea, nor is it a one-size-fits-all solution. Traditional training methods are still essential. However, a fully immersive sense of touch can bring many benefits to the industry in terms of reducing surgical errors and improving patient safety. In addition to gaining innovation, new surgical procedures are becoming mainstream faster.
Tactile fit for purpose
Looking to the future, the supplier’s goal must be a multi-mode platform that can provide all modes to support various levels of learning and training, depending on which stage the user is in for knowledge acquisition.
However, medical decision makers must get rid of the myth surrounding the development of touch. The goal is an artificial 3-D scene that provides the same sensory experience as in a real-world surgical environment. If there is no real tactile ability, any great intention will fail.
