Control of Surgical Gesture under Lingual Electro-Tactile Stimulation

TL;DR

This study evaluates the effectiveness of a lingual electrotactile device, the TDU, for guiding intracorporeal surgical punctures, showing it can accurately assist surgeons without prior visualization training.

Contribution

It demonstrates that the Tongue Display Unit can effectively guide surgical punctures and that prior visualization training does not enhance TDU-guided performance.

Findings

TDU provides accurate guidance for puncture tasks.

Training with visualization systems does not improve TDU performance.

TDU is a promising tool for minimally-invasive surgery guidance.

Abstract

Performing minimal-invasive surgical punctures require guiding a needle toward an intracorporeal clinically-defined target. As this technique does not involve cutting the body open, a visualization system is employed to provide the surgeon with indirect visual spatial information about the intracorporeal positions of the tool. One may consider that such systems reduce the ergonomics of the situation as they generate a decorrelation between the actual movement of the needle and the displayed information about this movement. The present study aims at assessing the guidance of an intracorporeal puncture under a lingual electrotactile sensory substitution device - the Tongue Display Unit (TDU) - with respect to the performance evidenced under a computer-rendered visualization system. The TDU device provides information about the deviation of the needle movement with regard to a pre-planned "optimal" trajectory. Experimental results show that - (1) the stimulations furnished by the TDU are efficient enough to guide accurately one's puncture, - and (2) that previous training using the visualization system does not improve performances obtained under subsequent TDU guidance. Finally, results are discussed in terms of efficiency and usability of the TDU in the context of guiding minimally-invasive surgical gesture.