Endo-Surgical Force Feedback System Design for Virtual Reality Applications in Medical Planning

Virtual reality (VR) applications for surgical planning and mentoring are currently becoming more widespread. Within these fields of applications, haptic systems are crucial to help the understanding of the feedback provided by the tissue during the interaction with the surgical tool. The accuracy of the VR scenario is related to many aspects, among them the ability of the haptic device to provide the force feedback and thus the adoption of proper characterization and modeling of the soft tissue behavior during deformation. This paper presents the current development concerning a VR environment to be equipped with a force feedback haptic device to simulate and experience clamping in colorectal surgery. The reaction at the clamp handle is provided starting from a FEA of the contact between the surgical tool and the tissue, coupled with the kinematic analysis of the mechanism. Connecting the virtual scenario to a microcontroller board, the reaction force is applied to the the haptic device, shaped as a clamping tool handle, so that the user may experience the tissue impedence during clamping. By simulations made through Simscape, a concept is evaluated according to some simulation paths that involve common scenarios of the virtual reality experience (such as collision, partial or total clamping operation). The novelty of the research regards the system design oriented to increase the accuracy of the soft tissue material behaviour through a preliminary off-line dedicated FEA investigation. Through Simulink simulations, the system design is verified so that the VR system set-up may be carried out. The results highlighted: (a) a good correspondence among the theoretical study of the reference kinematism that the haptic device must reproduce; (b) the implementation of a bilinear material model, derived off-line from FEA, is suitable to capture hyperelastic and geometric non-linearities of the soft tissue; (c) the feasibility of the open loop haptic control in accordance to the explored kinematism. The final goal of the research is to propose a system design approach able to tune the VR experince for teaching and mentoring through a in-house set-up easy to be tailored.