Force feedback requirements for efficient laparoscopic grasp control

During laparoscopic grasping, tissue damage may occur due to use of excessive grasp forces and tissue slippage, whereas in barehanded grasping, humans control their grasp to prevent slippage and use of excessive force (safe grasp). This study investigates the differences in grasp control during barehanded and laparoscopic lifts. Ten novices performed lifts in order to compare pinch forces under four conditions: barehanded; using tweezers; a low-efficient grasper; and a high-efficient grasper. Results showed that participants increased their pinch force significantly later during a barehanded lift (at a pull-force level of 2.63 N) than when lifting laparoscopically (from pull-force levels of 0.77 to 1.08 N). In barehanded lifts all participants could accomplish it safe grasp, whereas in laparoscopic lifts excessive force (up to 7.9 N) and slippage (up to 38% of the trials) occurred frequently. For novices, it can be concluded that force feedback (additional to the hand-tool interface), its in skin-tissue contact, is a prerequisite to maintain a safe grasp. Much is known about grasp control during barehanded object manipulation, especially the control of pinch forces to changing loading, whereas little is known about force perception and grasp control during tool usage. This knowledge is a prerequisite for the ergonomic design of tools that are used to manipulate objects.