Surgeons’ perceptions on the utility of a novel force sensor at the surgeon-tool interface: a qualitative interview study (Preprint)

BACKGROUND Real-time force feedback is essential in many surgical specialties. While previous research has focused on force measured at the tool-tissue interface, little work has explored the benefits, limitations, or opportunities of measuring force at the surgeon-tool interface. OBJECTIVE This study aims to explore scenarios in which surgeons from different medical specialties and experience levels could benefit from receiving feedback on the force exerted at the surgeon-tool (or surgeon-tissue) interface. METHODS Exploratory qualitative research was conducted through interviews with medical practitioners (n=15). This study explored perceptions of an exemplar novel force-sensing surgical glove that provided real-time feedback in terms of usability, utility, value, and limitations. Opportunities and barriers for the sensor’s implementation in clinical practice were also explored. Participants had experience in anaesthetics, dental surgery, plastic and dermatological surgery, general surgery, and obstetrics and gynaecology as these surgical fields all require precise feedback on exerted forces. RESULTS Participants identified two key areas where the force sensor could yield significant benefits; (1) It could enhance surgical training through objective skill assessment and quantifiable feedback; and (2) it could provide valuable insights into the forces applied during practice, particularly in scenarios where other sensory feedback is masked. Participants appreciated that a sensorised glove that can provide real-time force sensing at the surgeon-tool interface would allow for continued feedback irrespective of the instrument and integrate seamlessly into their current surgical workflow. Furthermore, as surgeons in some specialisms, e.g., Dental or Obstetrics and Gynaecology, perform manual tasks, having a sensorised glove will provide feedback in instances where they are physically manipulating tissue. However, participants expressed concerns about accurately defining safe force ranges due to the variability in patients’ anatomical structures and the potential interference with tactile sensation. CONCLUSIONS Surgeons from various clinical practices agreed that force-sensing at the surgeon-tool interface could be valuable and provide them with optimal versatility as to when they would adopt force-sensing. The sensorised glove could improve decision making and surgical outcomes when other sources of information guiding force exertion are masked. Conversely, it could be detrimental when organic information to guide force exertion is distorted when using the sensor. While the choice between interaction modalities is dependent on the accessibility of different senses during surgery, design suggestions as to where sensors are best placed on a sensorised glove are dependent on the instrument used or type of manual procedure conducted.