{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:48:43Z","timestamp":1792500523523,"version":"4.5.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Telesurgery has the potential to overcome geographical barriers in surgical care, yet data transmission latency remains a major challenge, impairing operator performance. Although haptic feedback may mitigate latency effects, optimal parameters, such as applied force, have not been well defined in the context of robotic surgical procedures. This study aimed to investigate how varying visual feedback latency and applied force levels affect task performance in an endovascular simulation and assess whether lower applied forces can mitigate performance degradation under latency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective, experimental, cross-sectional study, healthy volunteers aged 18 to 65 years performed guidewire advancement tasks using a custom-built endovascular simulator under 12 different combinations of latency (0, 100, 200, 400 ms) and applied force (0.6, 1.2, 1.8 N). The primary outcome was the duration (ms) during which participants maintained the target force during a 10-second period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 116 participants participated in the study. The median performance time was 5,890 ms (interquartile range, 4,550 to 7,150 ms). Increased latency significantly reduced performance, with the most pronounced drop (\u22121,380 ms) between 100 ms and 200 ms (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Lower applied force (0.6 N) was associated with significantly better performance compared with higher force (1.8 N), independent of latency (\u22121,097.5 ms,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Younger participants (18 to 25 years) outperformed older participants (55 to 65 years) across all conditions (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study confirms the detrimental effect of visual feedback latency on performance in simulated robotic surgical procedures and demonstrates that reduced applied force can partially compensate for increased latency. Therefore, optimizing force parameters may improve performance and safety in telesurgical systems, particularly for older operators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845261453087","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:05:18Z","timestamp":1784527518000},"page":"256-263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Applied Force on Latency-Induced Errors in Endovascular Procedures: Experimental Cross-Sectional Study"],"prefix":"10.1177","volume":"21","author":[{"given":"Vilius","family":"Dambrauskas","sequence":"first","affiliation":[{"name":"Kaunas University of Technology, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaidas","family":"Labunskas","sequence":"additional","affiliation":[{"name":"Kaunas University of Technology, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7866-0644","authenticated-orcid":false,"given":"Gabija","family":"\u017dymantait\u0117","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"August\u0117","family":"Melaikait\u0117","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art\u016bras","family":"Mackevi\u010dius","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7960-0562","authenticated-orcid":false,"given":"Gediminas","family":"Vait\u0117nas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaida","family":"Baltr\u016bnien\u0117","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigitas","family":"Urbonavi\u010dius","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Hospitalsenhed Midt, Viborg, Denmark"},{"name":"Institute of Clinical Medicine, Aarhus University, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustinas","family":"Bau\u0161ys","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Surgery and Oncology, Translational Health Research Institute, Faculty of Medicine, Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7823-2974","authenticated-orcid":false,"given":"Tomas","family":"Baltrunas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"Telesurgery prospects in delivering healthcare in remote areas","volume":"69","author":"Shahzad N","year":"2019","unstructured":"Shahzad N, Chawla T, and Gala T. Telesurgery prospects in delivering healthcare in remote areas. J Pak Med Assoc 2019; 69(suppl 1): S69\u2013S71.","journal-title":"J Pak Med Assoc"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-025-02333-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200204000-00005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003546"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-015-0522-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.1758"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11548-015-1306-y"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3504-z"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07681-7"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-021-01196-6"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-024-02153-9"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-024-01984-w"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.isurg.2025.05.001"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274328"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2024.1416719"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-017-1791-y"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-46641-8"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0b013e32831a478c"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2020.2987603"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/mi14010197"},{"key":"e_1_3_2_22_2","unstructured":"Paun S. Design and characterization of a vibrotactile haptic feedback system. Bachelor\u2019s Thesis University of Twente Enschede the Netherlands https:\/\/essay.utwente.nl\/76604\/ (2018 accessed 3 June 2025)."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.01.059"},{"key":"e_1_3_2_24_2","unstructured":"Hammerand J. The Robot Report: the Intuitive da Vinci 5\u2019s top design changes: \u2018this is groundbreaking for robotic surgery \u2019 https:\/\/www.medicaldesignandoutsourcing.com\/intuitive-da-vinci-5-design-changes-force-feedback-haptic\/ (2024 accessed 3 June 2025)."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1145\/3491101.3519678"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000525"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2045"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1117\/1.JMI.5.1.010902"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2024.104166"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.90324.2008"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.00131"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abd2558"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-40821-1"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2331"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.05.022"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00072.2022"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1038\/35096636"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2022.3180052"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2025.1567955"},{"key":"e_1_3_2_40_2","unstructured":"Zhang Q Liu J and Zhao G. Towards 5G enabled tactile robotic telesurgery. https:\/\/doi.org\/10.48550\/ARXIV.1803.03586 (2018 accessed 3 June 2025)."},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-024-02863-5"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/aisy.202300268"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2021.3071135"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261453087","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845261453087","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261453087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:18:55Z","timestamp":1792498735000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845261453087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/15569845261453087"],"URL":"https:\/\/doi.org\/10.1177\/15569845261453087","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}