Vaginal Tactile Imaging

Abstract

Changes in the elasticity of the vaginal walls, connective support tissues, and muscles are thought to be significant factors in the development of pelvic organ prolapse, a highly prevalent condition affecting at least 50% of women in the United States during their lifetimes. It creates two predominant concerns specific to the biomechanical properties of pelvic support tissues: how does tissue elasticity affect the development of pelvic organ prolapse and how can functional elasticity be maintained through reconstructive surgery. We designed a prototype of vaginal tactile imager (VTI) for visualization and assessment of elastic properties of pelvic floor tissues. In this paper, we analyze applicability of tactile imaging for evaluation of reconstructive surgery results and characterization of normal and pelvic organ prolapse conditions. A pilot clinical study with 13 patients demonstrated that VTI allows imaging of vaginal walls with increased rigidity due to implanted mesh grafts following reconstructive pelvic surgery and VTI has the potential for prolapse characterization and detection.

Biomechanical Properties and Associated Collagen Composition in Vaginal Tissue of Women with Pelvic Organ Prolapse

“…We observed that the vaginal wall was stiffer in cases than in controls. Results are consistent with data from a study using a proof of concept prototype of the vaginal tactile imager 25 and with data obtained by traditional uniaxial tension tests. 23 Overall the traditional uniaxial tension studies indicate that prolapse confers less elasticity and greater stiffness with low forces at failure.…”

Influence of body mass index on the biomechanical properties of the human prolapsed anterior vaginal wall

“…Its etiology is multifactorial and includes vaginal delivery as well as obesity, age, and menopause among the most common risk factors [2]. The anterior vaginal wall (AVW) compartment is the most commonly affected, resulting in a gradual descent of the bladder reaching to (stage II) or extending beyond (stage III) the vaginal introitus [3,4].…”

Instrumental tactile diagnostics in robot-assisted surgery

“…Certain studies were performed aimed at the improvement of force feedback in minimally invasive or robotic surgeries 7,8. However, the problem of tactile feedback was not adequately studied: the results were either preliminary from the viewpoint of clinical applications9–12 or not focused on surgery 13,14. At the same time, tactile feedback is essential for control of tissue interaction15 and cannot be completely substituted by visual or audio feedback 16,17…”