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Critical Reviews™ in Biomedical Engineering
SJR: 0.207 SNIP: 0.376 CiteScore™: 0.79

ISSN Druckformat: 0278-940X
ISSN Online: 1943-619X

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Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.2014011701
pages 293-318

A Perspective on the Role and Utility of Haptic Feedback in Laparoscopic Skills Training

Ravikiran Singapogu
Timothy Burg
Kansas State University
Karen J.L. Burg
institute for Biological Interfaces of Engineering, Clemson, South Carolina; Department of Bioengineering, Clemson University, Clemson, South Carolina; Department of Chemical Engineering, Kansas State University, Manhattan, Kansas
Dane E. Smith
institute for Biological Interfaces of Engineering, Clemson, South Carolina; Greenville Hospital System University Medical Center, Greenville, South Carolina
Amanda H. Eckenrode
Greenville Hospital System University Medical Center, Greenville, South Carolina;


Laparoscopic surgery is a minimally invasive surgical technique with significant potential benefits to the patient, including shorter recovery time, less scarring, and decreased costs. There is a growing need to teach surgical trainees this emerging surgical technique. Simulators, ranging from simple "box" trainers to complex virtual reality (VR) trainers, have emerged as the most promising method for teaching basic laparoscopic surgical skills. Current box trainers require oversight from an expert surgeon for both training and assessing skills. VR trainers decrease the dependence on expert teachers during training by providing objective, real-time feedback and automatic skills evaluation. However, current VR trainers generally have limited credibility as a means to prepare new surgeons and have often fallen short of educators' expectations. Several researchers have speculated that the missing component in modern VR trainers is haptic feedback, which refers to the range of touch sensations encountered during surgery. These force types and ranges need to be adequately rendered by simulators for a more complete training experience. This article presents a perspective of the role and utility of haptic feedback during laparoscopic surgery and laparoscopic skills training by detailing the ranges and types of haptic sensations felt by the operating surgeon, along with quantitative studies of how this feedback is used. Further, a number of research studies that have documented human performance effects as a result of the presence of haptic feedback are critically reviewed. Finally, key research directions in using haptic feedback for laparoscopy training simulators are identified.