Wang Jin, Yu Qing-Yuan, Li Wei, Wang Bing-Rui, Zhou Zhong-Rong
Tribology Research Institution, Key Laboratory for Advanced Technology of Materials of Ministry of Education, Southwest Jiaotong University, Cheng Du 610031, China.
Tribology Research Institution, Key Laboratory for Advanced Technology of Materials of Ministry of Education, Southwest Jiaotong University, Cheng Du 610031, China.
Clin Biomech (Bristol). 2017 Mar;43:58-66. doi: 10.1016/j.clinbiomech.2017.02.005. Epub 2017 Feb 10.
Tissue grasping damage often occurs in minimally invasive surgery, which would increase the postoperative recovery time and the risk of surgical complications. The purpose of this study was to evaluate the relationship between liver tissue trauma and compression stress magnitude and duration during tissue clamping operation.
The clamping experiments of liver tissues in vivo were conducted by using a universal soft tissue mechanical testing machine under different clamping stress magnitudes and durations. The rabbit liver was used to simulate human liver. A minimally invasive surgery grasper was used in these tests to simulate the real tissue-surgical operation condition. A pathological grading system was created to quantitatively assess the trauma within the liver tissue. The hyperbolic regression models were utilized to predict the trauma degree of liver tissue.
Obvious hyperemia, hemorrhage, hepatic capsule rupture and inflammatory cell infiltration appeared in the clamping sites of the liver. Assessment results indicated that the trauma degree increased nonlinearly with the increasing clamping stress and duration time. There exist safe thresholds, in which the severe trauma of the studied tissue can be avoided during grasping operation.
The results could provide the safety margins and the trauma prediction models for surgeons during grasping and palpation tasks in minimally invasive surgery.
组织抓持损伤在微创手术中经常发生，这会延长术后恢复时间并增加手术并发症的风险。本研究的目的是评估组织钳夹操作过程中肝组织创伤与压缩应力大小和持续时间之间的关系。
使用通用软组织力学试验机在不同的钳夹应力大小和持续时间下对体内肝组织进行钳夹实验。用兔肝模拟人肝。在这些测试中使用微创手术抓钳模拟真实的组织 - 手术操作条件。创建了一个病理分级系统来定量评估肝组织内的创伤。利用双曲线回归模型预测肝组织的创伤程度。
肝脏钳夹部位出现明显的充血、出血、肝包膜破裂和炎性细胞浸润。评估结果表明，创伤程度随着钳夹应力和持续时间的增加而非线性增加。存在安全阈值，在抓持操作过程中可以避免所研究组织的严重创伤。
这些结果可以为外科医生在微创手术中的抓持和触诊任务提供安全 margins 和创伤预测模型。
