Negating the Fulcrum Effect in Manual Laparoscopic Surgery: Investigating Skill Acquisition with a Haptic Simulator

Adam Spiers*, Sarah Baillie, Tony Pipe, George Asimakopoulos

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

3 Citations (Scopus)
1069 Downloads (Pure)


Background – Manual laparoscopic surgery requires extensive training and familiarization. It has been suggested that motion inversion caused by the ‘fulcrum effect’ is key to motor challenges. We investigate the potential of a conceptual semi-robotic handheld tool that negates natural inversion.

Methods – A custom laparoscopic simulator with haptic feedback was developed to allow interactive evaluation of the conceptual tool via virtual prototyping, prior to fabricating a physical prototype. Two groups of eight participants each used either the conceptual or a regular virtual tool over a ten week study to complete two abstract tasks of motor control and force regulation.

Results – Statistically significant higher rates of skill improvement were demonstrated with the conceptual tool for motion efficiency, task completion time and error reduction. Force regulation increased for both groups but without significant differences.

Conclusions – The results indicate potential for fulcrum-negating hand tools in reducing motor skill acquisition time.
Original languageEnglish
Article numbere1837
Number of pages12
JournalInternational Journal of Medical Robotics and Computer Assisted Surgery
Issue number4
Early online date23 May 2017
Publication statusPublished - 1 Dec 2017

Structured keywords

  • Veterinary Education Research Group


  • Laparoscopy
  • Minimally Invasive Surgery
  • Simulation
  • Training
  • Robot Design
  • Haptics
  • Human-Machine Interfaces
  • Virtual Reality
  • Fulcrum Effect


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