A Physical Simulator Integrated with Soft Sensors for Mastering Tissue Manipulation in Robotic Surgery

Robot-assisted minimally invasive surgery requires the surgeons to learn the new control dynamics of the surgical instruments and, usually, how to deal with the loss of haptic feedback. Indeed, excessive forces applied to delicate tissues as blood vessels may cause dramatic intraoperative events, such as major bleeding. Training plays a paramount role to prevent the onset of such adverse events. This work focuses on the development of an anatomy-based physical simulator of pulmonary vein for mastering tissue manipulation while using a surgical robot. The silicone-based simulator was integrated with soft strain sensors. Sensor data were characterized and used for objective skill assessment and for giving a visuo-acoustic feedback to the trainee. Preliminary user studies were carried out using the da Vinci surgical system, which lacks haptic feedback. These tests allowed us to assess the construct validity of the simulator, as well as the effectiveness of the feedback to reduce the stress applied to the vein. Future studies include an extensive validation of such a simulator as a training platform, specifically focusing on how this type of training later translates into clinical performances.