Tactile sensing technology for minimal access surgery - a review

Minimal access surgery (MAS), also known as keyhole surgery, offers many advantages over the more traditional open surgery. However, it possesses one very significant drawback-the loss, by the surgeon, of the sense of feel that is used routinely in open surgery to explore tissue and organs within the operative site. Because of this, important properties such as tissue compliance, viscosity and surface texture, which give indications regarding the health of the tissue, cannot easily be assessed. Restoring this tactile capability to MAS surgeons by artificial means would bring immense benefits in patient welfare and safety. Artificial tactile sensing systems for MAS are reviewed. The technology is addressed from different viewpoints including those of the basic transduction of tactile data (tactile sensing), the computer processing of the transduced data to obtain useful information (tactile data processing) and the display to the surgeon of this information (tactile display). Applications of tactile sensing in MAS, both to mediate the manipulation of organs and to assess the condition of tissue, are reviewed. Some attempts to add tactile feedback to laparoscopic surgery simulation systems for MAS surgeon training are also described. (C) 2003 Elsevier Ltd. All rights reserved.