Next-generation haptic technologies have recently appeared in a growing number of consumer devices, including gaming peripherals, digital music instruments, wellness wearables and beyond. Powered by ‘wideband’ haptics, this new kind of miniature vibrating motors are capable of delivering natural, realistic tactile sensations. Whilst these were initially developed with gaming in mind, they have now found their place in surgical training.
Surgeons have been using VR simulators to learn minimally invasive surgical skills for well over 20 years, gradually benefiting from the improvements in graphics gained from gaming engines and GPUs. This approach to learning manual surgical skills is now set for a huge upgrade, as Swiss medical simulation company, VirtaMed, teams up with Lofelt, a German technology company that develops advanced haptics for natural, realistic tactile experiences.
In 1976, Sega‘s motorbike game Moto-Cross, was the first game to use haptic feedback, causing the handlebars to vibrate during a collision with another vehicle. Other racing games added force feedback and rumble haptics to steering devices in the mid-to-late ’80s. In 1997, early haptic implementations within joysticks and controllers were provided through optional components, such as the Nintendo 64 controller’s Rumble Pak or the Microsoft SideWinder Force Feedback Pro with built-in feedback. Over the past 20 years, simple haptic devices have become commonplace in the likes of game controllers, joysticks and steering wheels. It is fair to say that these devices have not evolved with the precision needed for sensitive industrial environments, such as medical training.
The partnership ushers in a new era of active haptics – where new technologies such as the Lofelt L5 haptic actuator are used to deliver lifelike sensations for surgical simulation. This leap forward removes the dependency on having anatomically correct physical structures, while still providing the surgeon with a realistic tactile experience.
Harry Houdini once said: “what the eyes see and the ears hear, the mind believes.” Today’s simulators include very realistic visuals, with both an anatomical mannequin and the latest in VR graphics showing the laparoscopic view. To boost the realism further, simulators also provide an immersive audioscape that include sounds of patient monitoring equipment captured in the operating room. In other words, haptic feedback adds another layer of sensory input that allows the surgeon to suspend their disbelief that the simulation is any different from reality.
VirtaMed has even been able to design virtual organs that possess their own physical characteristics – such as the liver being much denser than the gallbladder that is next to it. This allows surgeons to clearly distinguish between different organs in a simulated case, and therefore perform operations such as removing the gallbladder much more realistically. And because these virtual organs respond to gravity, when surgeons position their patient via the abdominal model, the virtual organs settle into place as they would in real life. Using such advanced haptics, it is now possible to simulate lifting these organs up, cutting them, or even stopping them bleeding.
The progression of VR (Virtual Reality) and Haptics from gaming rooms to training rooms is quite literally a lifesaver, especially during a pandemic. Training healthcare professionals is vital for all societies, providing us with the nurses, doctors and surgeons of the future. COVID has meant that the global healthcare community has shifted its focus on emergency care rather than education – for painfully obvious reasons. As the world gets to grip with this pandemic we have seen many elective procedures cancelled and the contact between healthcare professionals and patients has been restricted. Under normal circumstances, medical procedures are taught in an apprenticeship model – currently, therefore, many trainees have been left without the ability to train. When we finally return to some kind of ‘normal’ and COVID restrictions have been relaxed, there will surely be a backlog of exams and elective procedures – further reducing available training opportunities.
The simulators of today, with all of their advanced technology, can certainly provide relief here. And whilst no single element makes a simulator, the haptics, the visuals, the training cases, the metrics and curriculum, can all work together to enable a trainee to progress.