Abstract
Soft tissue palpation remains one of the most challenging skill sets to acquire in minimally invasive laparoscopic surgery due to the attenuation of tactile feedback inherent in long-shafted surgical instruments. Virtual reality (VR) surgical simulators offer risk-free training environments, yet conventional haptic interfaces frequently rely on single-mode force reflection, failing to convey both bulk viscoelastic tissue resistance and subtle micro-textured surface variations. This study evaluates a novel dual-actuator haptic glove system combining pneumatic micro-fluidic force-feedback bladders (kinesthetic) with high-density linear resonant actuators (vibrotactile) for laparoscopic soft tissue palpation training. Thirty surgical residents evaluated the system across three experimental conditions: Dual-Actuator (DA), Single-Actuator Vibrotactile (SAV), and Standard VR Controllers (SVC). Participants performed simulated organ palpation tasks to detect embedded sub-surface tumors and categorize viscoelastic compliance across organ models. The DA glove system yielded significantly higher stiffness discrimination accuracy (89.4%) compared to SAV (68.2%) and SVC (51.3%, p < 0.001). Furthermore, the DA condition reduced peak applied force during palpation by 34.2%, significantly lowering simulated tissue trauma events. Subjective evaluation via the System Usability Scale (SUS) yielded an average score of 84.6 for the DA interface. These findings demonstrate that integrating dual-actuation modalities bridges the sensory fidelity gap in VR surgical simulation, offering a superior platform for acquiring nuanced tactile diagnostic skills prior to clinical practice.
