Real-Time Intraoperative Pressure Monitoring to Avoid Surgically Induced Localized Brain Injury Using a Miniaturized Piezoresistive Pressure Sensor

Abstract

Neurosurgical procedures often cause damage to the brain tissue at the periphery from surgical manipulations. Especially during retraction, a large amount of pressure could be applied on the brain surface, which can damage it, leading to brain herniation, which can be fatal for patients. To resolve this issue, we have developed a pressure sensor that can be used to monitor the applied pressure during surgery for intraoperative care. This device was tested on a rodent model to create a superficial surgically induced damage profile for three different applied pressures (30, 50, and 70 mmHg) and compared to a standard intracranial pressure monitoring system. Magnetic resonance imaging has been performed after surgical procedures to detect the herniation caused by applied pressure. To evaluate the damage to brain cells and tissue rupture, histological analysis was performed using hematoxylin and eosin staining. A scoring system was developed to understand the severity of the surgically induced brain injury, which will help neurosurgeons to limit the pressure to an optimum point without causing damage.

Recent progress of flexible pressure sensors: from principle, structure to application characteristics

“…Karmakar et al [128] designed a miniature PRF pressure sensor to monitor the instrument pressure applied to the brain surface during neurosurgery. Poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) composite film doped with graphene oxide (GO) was used as the core sensing material, and PET film coated with flexible ITO was used as the substrate to prepare the interdigital electrode.…”

Applications of flexible electronics related to cardiocerebral vascular system

“… Neurodegenerative diseases, etc. [ 145 , 156 , 160 , 185 , 259 , 324 , 318 , 319 , [313] , [325] , [326] , [327] , [328] , [329] , [330] , [331] , [332] , [333] , [334] ] …”

Recent developments in stretchable and flexible tactile sensors towards piezoresistive systems: A review

“…Further, in the surgical tool field, to avoid localized brain injury during surgery, a piezoresistive sensor has been developed for real-time pressure monitoring. 315 Similarly, for drug delivery monitoring, a hydrogel-shielded soft tactile sensor was designed. 176 Origamiinspired surgical retractors with stiffness and tactile sensing sensors also showed promising results in safer instrument-tissue interaction.…”

“…The tissue interaction with the collision‐aware surgical robot is shown in Figure 17B. Further, in the surgical tool field, to avoid localized brain injury during surgery, a piezoresistive sensor has been developed for real‐time pressure monitoring 315 . Similarly, for drug delivery monitoring, a hydrogel‐shielded soft tactile sensor was designed 176 .…”