Effect of haptic feedback in laparoscopic surgery skill acquisition

Surg Endosc. 2012 Apr;26(4):1128-34. doi: 10.1007/s00464-011-2011-8. Epub 2011 Nov 2.


Background: The benefits of haptic feedback in laparoscopic surgery training simulators is a topic of debate in the literature. It is hypothesized that novice surgeons may not benefit from the haptic information, especially during the initial phase of learning a new task. Therefore, provision of haptic feedback to novice trainees in the early stage of training may be distracting and detrimental to learning. A controlled experiment was conducted to examine the effect of haptic feedback on the learning curve of a complex laparoscopic suturing and knot-tying task.

Methods: The ProMIS and the MIST-VR surgical simulators were used to represent conditions with and without haptic feedback, respectively. A total of 20 novice subjects (10 per simulator) were trained to perform suturing and knot-tying and practiced the tasks in 18 sessions of 1 h each.

Results: At the end of the 3-week training period, the subjects performed equally fast but more consistently with haptics (ProMIS) than without haptics (MIST-VR). The subjects showed a slightly higher learning rate and reached the first plateau of the learning curve earlier with haptic feedback.

Conclusion: In general, learning with haptic feedback was significantly better than learning without it for a laparoscopic suturing and knot-tying task, but only during the first 5 h of training. Haptic feedback may not be warranted in laparoscopic surgical trainers. The benefits of a shorter time to the first performance plateau and more consistent initial performance should be balanced with the cost of implementing haptic feedback in surgical simulators.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Clinical Competence / standards*
  • Computer Simulation
  • Education, Medical, Graduate / methods
  • Education, Medical, Undergraduate / methods
  • Equipment Design
  • Feedback*
  • Female
  • Humans
  • Internship and Residency / methods*
  • Laparoscopy / education*
  • Laparoscopy / standards
  • Learning Curve
  • Male
  • Manikins
  • Suture Techniques / education*
  • Suture Techniques / standards
  • Teaching Materials
  • Time Factors
  • Young Adult