MEMSurgery: an integrated test-bed for vascular surgery

Abstract

Many surgical procedures require skillful manipulations of blood vessels, especially in conventional invasive or minimally invasive surgical procedures. Current surgical methods do not allow the surgeon to receive any real time feedback of the tissue properties when operating on the vessel. As a result, the unintentional application of excessive force may damage the blood vessel. To minimize such trauma, and to study the interaction of surgical instruments with the vessel structure, we have developed an integrated surgical testbed called MEMSurgery (Microelectromechanical Sensory augmented Surgery). The test-bed integrates four elements: a) force sensors mounted on surgical appliances, b) a feedback control mechanism utilizing the intrinsic mechanical properties of the blood vessel, c) feedback of the force applied on the tissue back to the surgeon through a haptic feedback device, and d) visual feedback by a graphical computer model of the vessel. Finally, we evaluate the performance of MEMSurgery by testing the hypothesis that the combination of haptic feedback, feedback control based on vascular mechanical properties, and real-time visual representation of the vessel will help the surgeon decrease the probability of applying excess force while occluding the blood vessel. To this end, we designed a rodent experimental model to obtain the ideal minimum occlusion force (MOF). After a series of human performance studies, and subsequent comparison to direct application of force on the forceps (without feedback), the results show that the probability of applying reasonable MOF increases from 35.5% to 80%. After a brief training period, the probability increases to 90%.

Mechanical analysis of end‐to‐end silk‐sutured anastomosis for robot‐assisted surgery

“…The force applied to organic tissue can only be estimated through visual feedback by observing the deformation of the tissue (5). Researchers are seeking feasible solutions to tissue manipulation by adding force measurement and feedback to robotic systems (6)(7)(8)(9)(10)(11)(12)(13)(14) and designing instruments to identify tissue propertiues (15)(16)(17)(18)(19). Such attempts are still not sufficient to enhance the quality of actual operations, due to a lack of the specific or excessive force applied on the end effectors needed in surgical operations.…”