• Layard HorsfallHugoH0000-0001-7848-5325Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK., Carmen Salvadores Fernandez, Biswajoy Bagchi, Priyankan Datta, Priya Gupta, Chan Hee Koh, Danyal Khan, William Muirhead, Adrien Desjardins, Manish K Tiwari, and Hani J Marcus.
• Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
• Neurosurgery. 2023 Mar 1; 92 (3): 639646639-646.

BackgroundMeasuring intraoperative forces in real time can provide feedback mechanisms to improve patient safety and surgical training. Previous force monitoring has been achieved through the development of specialized and adapted instruments or use designs that are incompatible with neurosurgical workflow.ObjectiveTo design a universal sensorised surgical glove to detect intraoperative forces, applicable to any surgical procedure, and any surgical instrument in either hand.MethodsWe created a sensorised surgical glove that was calibrated across 0 to 10 N. A laboratory experiment demonstrated that the sensorised glove was able to determine instrument-tissue forces. Six expert and 6 novice neurosurgeons completed a validated grape dissection task 20 times consecutively wearing the sensorised glove. The primary outcome was median and maximum force (N).ResultsThe sensorised glove was able to determine instrument-tissue forces reliably. The average force applied by experts (2.14 N) was significantly lower than the average force exerted by novices (7.15 N) ( P = .002). The maximum force applied by experts (6.32 N) was also significantly lower than the maximum force exerted by novices (9.80 N) ( P = .004). The sensorised surgical glove's introduction to operative workflow was feasible and did not impede on task performance.ConclusionWe demonstrate a novel and scalable technique to detect forces during neurosurgery. Force analysis can provide real-time data to optimize intraoperative tissue forces, reduce the risk of tissue injury, and provide objective metrics for training and assessment.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.

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