Haptic Feedback and Tremor Suppression in Teleoperated Surgical Robotics for Improved Precision

Background: Teleoperated surgical robotics offers enhanced dexterity and access but remains constrained by limited haptic information and operator physiological tremor. Combining high-fidelity haptic feedback with active tremor suppression may improve task precision in minimally invasive procedures. Methods: We developed a bilateral teleoperation testbed integrating configurable haptic rendering (kinesthetic only; combined tactile and kinesthetic) and an adaptive tremor suppression module based on velocity-adaptive filtering and model-based compensation. Thirty-six surgical residents and engineers performed three representative microsurgical tasks (needle placement, fine suture threading, and planar peg transfer) under four control conditions: (1) no haptics, (2) kinesthetic feedback, (3) combined tactile+kinesthetic feedback, and (4) combined feedback with tremor suppression. Primary outcomes were positional error (mm), tremor amplitude (RMS, mm), and task completion time (s). Statistical analysis comprised repeated-measures ANOVA and mixed-effects regression to quantify independent contributions of haptic modality and tremor suppression. Results: Combined tactile+kinesthetic feedback significantly reduced mean positional error relative to no haptics (mean difference 0.42 mm, p < .01) and kinesthetic-only (0.19 mm, p = .04). Adding tremor suppression yielded the largest improvement (mean error reduction vs. no haptics 0.73 mm, p < .001) and reduced tremor amplitude by 68% relative to no-haptics baseline. Mixed-effects regression indicated that tactile feedback and tremor suppression were independent, additive predictors of reduced positional error (β = -0.18, p = .02; β = -0.35, p < .001, respectively). Conclusions: High-fidelity combined haptic feedback improves teleoperated surgical precision; integrating adaptive tremor suppression provides additional, substantial benefit. These results support clinical translation of multisensory haptic interfaces with active tremor mitigation to enhance microsurgical outcomes, and they suggest guidelines for design trade-offs between feedback fidelity and control filtering in surgical teleoperation.