A tactile sensor for laparoscopic cholecystectomy

Abstract

During laparoscopic surgery, surgeons observe the three-dimensional abdominal cavity on a two-dimensional TV monitor, which is a limitation. Another limitation is that surgeons are unable to estimate the softness of organs or tissues during laparoscopic surgery as they are only allowed to use instruments which touch objects and direct palpation is not permitted during the procedure. The tactile sensor which we used displays the object softness immediately as a digital score, which can then be superimposed on a TV monitor as a graph. With the tactile sensor, we were able to ascertain the presence of a gallstone in the gallbladder or cholecystic duct during laparoscopic cholecystectomy and also able to discriminate between a stone and an air bubble during intraoperative cholangiography. We were convinced that the tactile sensor would be useful in laparoscopic surgery, which does not permit surgeons to palpate objects with human fingers.

Tactile Devices To Sense Touch on a Par with a Human Finger

“…While significant progress has been made over the last three decades in these areas, the lack of high‐performance tactile sensors has been recognized as one of the critical bottlenecks 22. For example, today a surgeon operating by MIS is primarily dependent on his/her vision, thus making it difficult to decipher cancerous tissue from normal tissue, because it is not possible to “feel” the texture5 or distinguish between stones and air bubbles during a laparoscopy 7. Thus, if tools, ranging from a simple catheter to a microrobot could be covered with an electronic skin, the sophistication of MIS and its potential applications could be greatly improved, thereby reducing patient recovery time and cost.…”

Tastsysteme mit künstlichem Tastsinn wie beim menschlichen Finger

“…Zwar wurden in den letzten drei Jahrzehnten deutliche Fortschritte in diesen Bereichen erzielt, aber das Fehlen von Hochleistungstastsensoren hat sich als entscheidender Engpass herausgestellt 22. Beispielsweise operiert ein Chirurg bei der MIS zurzeit nur mithilfe seines Sehvermögens; wenn man keine Textur “fühlen” kann,5 ist es schwierig, Tumorgewebe und normales Gewebe zu identifizieren oder bei einer Laparoskopie zwischen Steinen und Luftblasen zu unterscheiden 7. Wenn man daher die Werkzeuge, seien es einfache Katheter oder komplexe Mikroroboter, mit einer elektronischen Haut versehen könnte, ließe sich die MIS erheblich verbessern, wodurch die Genesungszeiten der Patienten verkürzt und die Behandlungskosten reduziert würden.…”

In Vivo Measurement of Surface Pressures and Retraction Distances Applied on Abdominal Organs During Surgery

“…Force sensing capability has been considered in robotic-assisted surgery and MIS. 2-4 In vivo mechanical properties of human soft tissues and organs have been reported during endoscopic, 5 MIS, 6 and open abdominal surgery. 7 Grasping forces have been measured during retraction of major abdominal organs in an in vivo porcine model using a fenestrated grasper.…”