ReviewAnnals of medicine and surgery (2012)2021
Tool-tissue forces in surgery: A systematic review.
Review in Annals of medicine and surgery (2012), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review on Haptic Feedback in Medical Robotics: Technologies, Applications, Clinical Translation, and an Information-Oriented Perspective.Sensors (Basel, Switzerland) · 2026Pooled it
- Artificial intelligence applications in surgical education and training: a systematic review.Frontiers in artificial intelligence · 2026Pooled it
- A highly sensitive and drift-free iontronic sensor enabled by a polarity-balanced polyelectrolyte for surgical force sensing.Science advances · 2026Article
- Physics-Informed Generative Framework to Unsupervised Biomechanical Parameter Estimation for Tool-Tissue Force Prediction from Laparoscopic Depth Maps.Bioengineering (Basel, Switzerland) · 2026Article
- Surgeons' Perceptions on the Utility of a Conceptual Novel Force Sensor at the Surgeon-Tool Interface: Formative Interview Study.JMIR formative research · 2026Article
- Path planning for fracture reduction robots incorporating physiological tissue response and safety-oriented optimization.International journal of computer assisted radiology and surgery · 2026Article
- Exploring video recognition models for force estimation in small bowel surgical retractions.International journal of computer assisted radiology and surgery · 2026Article
- Sensorized Vascular High-Fidelity Physical Simulator for Robot-Assisted Surgery Training: A Multisite Pilot Evaluation.Journal of clinical medicine · 2026Article
- Design and Validation of a Grasping Force Measuring Vibrotactile Feedback Add-On for Laparoscopic Instruments.IEEE journal of translational engineering in health and medicine · 2026Article
- Robust prediction of tool-tissue interaction force using ISSA-optimized BP neural networks in robotic surgery.BMC surgery · 2025Article
- Magnetic Fluid-Driven Vine Robots for Minimally Invasive Tissue Biopsy Sampling.Advanced intelligent systems (Weinheim an der Bergstrasse, Germany) · 2025Article
- Smartwatch-based wrist tremor assessment in neurosurgical simulator training.Scientific reports · 2025Article
- Work-related musculoskeletal pain among orthopaedic surgeons: A systematic literature search and narrative synthesis.Journal of clinical orthopaedics and trauma · 2025Review
- Investigation of the mechanical frequency response of ovine renal tissue at low frequencies.Scientific reports · 2025Article
- Initial experience with surgical humidification to prevent tissue dehydration during pterional craniotomy for aneurysm clipping: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Role of haptic feedback technologies and novel engineering developments for surgical training and robot-assisted surgery.Frontiers in robotics and AI · 2025Review
- Skill progress during a dedicated societal robotic surgery training curriculum including several robotic surgery platforms.Surgical endoscopy · 2024Observational
- A Review of Recent Advancements in Sensor-Integrated Medical Tools.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Review
- A high sensitivity, low cost and fully decoupled multi-axis capacitive tactile force sensor for robotic surgical systems.PloS one · 2024Article
- Medical student perception of force application: An accuracy assessment and pilot training program.Journal of education and health promotion · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundExcessive tool-tissue interaction forces often result in tissue damage and intraoperative complications, while insufficient forces prevent the completion of the task. This review sought to explore the tool-tissue interaction forces exerted by instruments during surgery across different specialities, tissues, manoeuvres and experience levels. MATERIALS &
methodsA PRISMA-guided systematic review was carried out using Embase, Medline and Web of Science databases.
resultsOf 462 articles screened, 45 studies discussing surgical tool-tissue forces were included. The studies were categorized into 9 different specialities with the mean of average forces lowest for ophthalmology (0.04N) and highest for orthopaedic surgery (210N). Nervous tissue required the least amount of force to manipulate (mean of average: 0.4N), whilst connective tissue (including bone) required the most (mean of average: 45.8). For manoeuvres, drilling recorded the highest forces (mean of average: 14N), whilst sharp dissection recorded the lowest (mean of average: 0.03N). When comparing differences in the mean of average forces between groups, novices exerted 22.7% more force than experts, and presence of a feedback mechanism (e.g. audio) reduced exerted forces by 47.9%.
conclusionsThe measurement of tool-tissue forces is a novel but rapidly expanding field. The range of forces applied varies according to surgical speciality, tissue, manoeuvre, operator experience and feedback provided. Knowledge of the safe range of surgical forces will improve surgical safety whilst maintaining effectiveness. Measuring forces during surgery may provide an objective metric for training and assessment. Development of smart instruments, robotics and integrated feedback systems will facilitate this.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.