Assessment of Tissue Damage due to Mechanical Stresses

摘要: While there are many benefits to minimally invasive surgery (MIS), force feedback or touch sensation is limited in the currently available MIS tools, such as surgical robots, creating potential for excessive application during and unintended tissue injury. The goal of this work was develop a methodology with which identify stress magnitudes durations that can be safely applied grasper di ferent tissues, potentially improving device design reducing adverse clinically relevant consequences. Using porcine model, stresses typically were liver, ureter small bowel using motorized endoscopic grasper. Acute indicators damage including cellular death infiltration inflammatory cells measured histological image analysis techniques. Finite element used approximate distributions experienced by tissues. Parameters these finite models specifically reflected properties served an initial proxy all rather than absolute values desired. Local regions predicted have uniform computational mapped analyzed samples acute damage. Analysis variance (ANOVA) post-hoc analyses detect caused significantly increased ultimately safe `thresholds' grasping studied Preliminary data suggests graded non-linear response between magnitude apoptosis liver well neutrophil bowel. appeared more resistant injury at tested levels. By identifying within range loads MIS, it may possible researchers create `smart' robot guide surgeon manipulate tissues minimal resulting In addition, simulator improved reflect realistic responses evaluate trainees' handling skills.