Assessment of navigation cues with proximal force sensing during endovascular catheterization.

Despite increased use of robotic catheter navigation systems for endovascular intervention procedures, current master-slave platforms have not yet taken into account dexterous manipulation skill used in traditional catheterization procedures. Information on tool forces applied by operators is often limited. A novel force/torque sensor is developed in this paper to obtain behavioural data across different experience levels and identify underlying factors that affect overall operator performance. The miniature device can be attached to any part of the proximal end of the catheter, together with a position sensor attached to the catheter tip, for relating tool forces to catheter dynamics and overall performance. The results show clear differences in manipulation skills between experience groups, thus providing insights into different patterns and range of forces applied during routine endovascular procedures. They also provide important design specifications for ergonomically optimized catheter manipulation platforms with added haptic feedback while maintaining natural skills of the operators.