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Laparoscopic surgery , perceptual limitations and force : A review

Laparoscopic surgery (LS) has become the standard in procedures such as cholecystectomy and splenectomy. However, LS imposes limitations in visual and haptic perceptions, and create challenges unique to this type of surgery: reduced depth perception of the operative field caused by the use of 2D monitors; poor hand-eye coordination as a result of location of the monitor, variable amplification, mirrored movement, and misorientation; motion limitations due to trocar-induced invariant points, and reduced haptic feedback from the use of long and slender surgical instruments. One of the major concerns with laparoscopic surgery is potential for tissues damage, possibly caused by inappropriate use of force. Providing force feedback, either direct or augmented by visual/audio means, has the potential to improve laparoscopic surgical performance by reducing the peak force used during LS, and in turn reduce intra-operative injury to patients.