Lack of haptic feedback has been identified as a barrier to adoption of robotic platforms, particularly during gastrointestinal procedures as they require both grasping and shear sensation to perform delicate anastomoses and dissections. The present proposal will further develop the capabilities of a Haptic Feedback System (HFS) to deliver this bi-axial sensory information from the surgical graspers to the fingertips of the operating surgeon in a robotic platform. The current HFS detects grasping forces via piezoresistive sensors, delivering this signal wirelessly through pneumatic balloon actuators. Previous results have shown that when using the HFS surgeons perform tasks more quickly with decreased grasping force, thereby resulting in decreased tissue damage. However, the current system is limited by its size and its uniaxial capabilities. Thus, novel capacitive tooth sensor microarrays were developed resulting in a wider range of force sensation along with an improved ability to withstand biological environments. Based on this superior performance, we have designed a bi-axial microarray to accommodate both grasping and shear forces. The present studies will fabricate these sensor arrays, characterize and integrate them within the current HFS framework, and evaluate their impact in gastrointestinal procedures. Specifically, we focus on the RouxenY Gastric Bypass as it has recently garnered more support in translation to the robotic platform. We will evaluate the effect of auxiliary haptic feedback on grp force, shear force, anastomosis integrity, surgical duration, surgical complications, and tissue damage in a porcine model. In addition, we will perform human feasibility trials for Totally Robotic RouxenY Gastric Bypass with haptic feedback to further translate the HFS towards comprehensive clinical trials.
This project will develop a new bi-axial capacitive based sensor and corresponding vibrotactile actuator system to be integrated with the current pneumatic Haptic Feedback System (HFS) for use in gastrointestinal surgical procedures. This proposal builds on previous work to translate a novel and more commercially viable HFS into preclinical and clinical models to assess safety and efficacy. Our efforts will be focused specifically on the Roux- en-Y Gastric Bypass procedure due to the recent increase in robotic platform use for this procedure, and great potential for a reduction in complications and procedure time using HFS equipped robots.