Role of haptic feedback technologies and novel engineering developments for surgical training and robot-assisted surgery

Imán Laga Boul-Atarass^1,2Mercedes Rubio Manzanares Dorado¹Andrés Padillo Eguía³Jesús Racero Moreno³Ignacio Eguía Salinas³Sheila Pereira Arenas^1,2Rosa María Jiménez Rodríguez¹Javier Padillo Ruiz^1,2*

• ¹Department of General Surgery, Virgen del Rocío University Hospital, Seville, Spain
• ²Oncology Surgery, Cell Therapy, and Organ Transplantation Group, Institute of Biomedicine of Seville, Seville, Spain
• ³Higher Technical School of Engineering, University of Seville, Seville, Spain

Haptic feedback, or tactile perception, is presented by many authors as a technology that can greatly impact biomedical fields, such as minimally invasive surgeries. Laparoscopic interventions are considered the gold standard for many surgical interventions, providing recognized benefits, such as reduced recovery time and mortality rate. In addition to this, the advances in robotic engineering in the last few years have contributed to the increase in the number of robotic and tele-operated interventions, providing surgeons with fewer hand tremors and increased depth perception during surgery. However, currently, both techniques are totally or partially devoid of haptic feedback. This added to the fact that the skill acquisition process to be able to use these technologies shows a pronounced learning curve, has propelled biomedical engineers to aim to develop safe and realistic training programs using simulators to address surgical apprentices' needs in safe environments for the patients. This review aims to present and summarize some of the latest engineering advances reported in the current literature related to the development of haptic feedback systems in surgical simulators and robotic surgical systems, as well as highlight the benefits that these technologies provide in medical settings for surgical training and preoperative rehearsal.