A force-sensing microsurgical instrument that detects forces below human tactile sensation.

摘要: Many clinical procedures involve intervention and manipulation of extremely small, delicate tissue structures. Vitreoretinal surgery is a prime example the requirement for micron-scale maneuvers. The vitreoretinal structures inside eye poses enormous challenges because fragility, surgical inaccessibility, suboptimal visualization, potential irreversible damage resulting from unintentional movement. Epiretinal membrane (ERM) peeling prototypical task where delaminating thin off retina with microforceps well below threshold human tactile perception.1 Imprecise movements or unexpected patient movement can induce excessive forces that lead to injury, such as retinal hemorrhage tearing, vision loss. surgeons visually monitor local surface deformation surrogate sensation during peeling. imperceptible sensation, subtle visual cues substitute force generation, need very precise, minute visuomotor reflexes makes one most difficult ophthalmologic tasks perform. Surgical instruments detect maneuver could enable surgeon complete greater ease fewer complications. Previous force-sensing microsurgical had elements built into handle instrument.2-4 Because this handle-mounted tool sensor design, these tools do not give useful information generated by interactions between shaft sclera at sclerotomy interfered accurate measurement tool-to-tissue interaction (e.g., retina). Jagtap Riviere reported exactly problem when using handle-based measure microsurgery went on state, “It seems likely discrimination applied tip due contact be significant challenge in development feedback microsurgery.”3 We have recently addressed limitation incorporating section instrument located eye.5 We hypothesized new technology measures generation procedure will improve performance diminish complication. To provide benefit surgeon, both are any library injury necessary. achieve goal, engineering effort has been put designing optimizing sensor-integrated would suitable use live animal eye. probe tip, although optimal bonding positioning shift, improved uniformity three fiber sensors show robust-ness, linearity reliability compared previous version. In study, therefore, we sought test whether our newly designed reliably (millinewton scale) phantom systems distinguish normal maneuvers known also tested vitrectomy rabbit demonstrate did interfere measurements 1) safe delamination posterior hyaloid retina, 2) creation tear.