Visuo-Haptic Feedback and Extended Reality in Microinvasive Cardiac Surgery: A Next-Generation Simulator for Mitral Valve Repair

Mitral regurgitation is a structural heart disease characterized by dysfunction of the mitral valve. It can be treated through minimally invasive transcatheter edge-to-edge repair procedures, such as those involving the MitraClipTM system. Despite its clinical efficacy, the procedure poses technical challenges, requiring interventional cardiologists to undergo multiple procedures to achieve instrumentation proficiency. Previous studies have demonstrated the efficacy of extended reality simulators in improving surgical skill training. The purpose of this study is to evaluate the effectiveness of visuo-haptic feedback within an extended reality simulator to accelerate and enhance the learning process for the MitraClipTM procedure, potentially offering a valuable tool in surgical training. In this study, based on the prototype of our previous simulator, we further implemented a novel cardiac dynamic environment, a visual feedback interface, an innovative haptic armband, and a new model of the catheter to enhance the simulator’s fidelity and educational usability. Experiment results demonstrated that users benefiting from visuo-haptic feedback exhibited significantly reduced completion times, reduced deviation from predefined trajectories, and presented safer navigation results. Moreover, users preferred the visuo-haptic feedback experience, highlighting its perceived value in enhancing training. These findings underscore the potential of adding visuo-haptic feedback to extended reality simulators in surgical training for complex procedures, improving proficiency and patient surgery outcomes.