Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK.
Neurosurgery. 2023 Mar 1;92(3):639-646. doi: 10.1227/neu.0000000000002239. Epub 2022 Dec 12.
Measuring intraoperative forces in real time can provide feedback mechanisms to improve patient safety and surgical training. Previous force monitoring has been achieved through the development of specialized and adapted instruments or use designs that are incompatible with neurosurgical workflow.
To design a universal sensorised surgical glove to detect intraoperative forces, applicable to any surgical procedure, and any surgical instrument in either hand.
We created a sensorised surgical glove that was calibrated across 0 to 10 N. A laboratory experiment demonstrated that the sensorised glove was able to determine instrument-tissue forces. Six expert and 6 novice neurosurgeons completed a validated grape dissection task 20 times consecutively wearing the sensorised glove. The primary outcome was median and maximum force (N).
The sensorised glove was able to determine instrument-tissue forces reliably. The average force applied by experts (2.14 N) was significantly lower than the average force exerted by novices (7.15 N) ( P = .002). The maximum force applied by experts (6.32 N) was also significantly lower than the maximum force exerted by novices (9.80 N) ( P = .004). The sensorised surgical glove's introduction to operative workflow was feasible and did not impede on task performance.
We demonstrate a novel and scalable technique to detect forces during neurosurgery. Force analysis can provide real-time data to optimize intraoperative tissue forces, reduce the risk of tissue injury, and provide objective metrics for training and assessment.
实时测量术中力可以提供反馈机制,以提高患者安全性和手术培训水平。以前的力监测是通过开发专门的和适配的仪器或使用与神经外科工作流程不兼容的设计来实现的。
设计一种通用的传感器手术手套,以检测术中力,适用于任何手术程序和任何一只手中的任何手术器械。
我们创建了一种经过校准的传感器手术手套,可测量 0 到 10 N 的力。实验室实验表明,传感器手术手套能够确定器械与组织的力。6 名专家和 6 名新手神经外科医生连续 20 次戴着传感器手术手套完成了经过验证的葡萄分离任务。主要结果是中位数和最大力(N)。
传感器手术手套能够可靠地确定器械与组织的力。专家施加的平均力(2.14 N)明显低于新手施加的平均力(7.15 N)(P =.002)。专家施加的最大力(6.32 N)也明显低于新手施加的最大力(9.80 N)(P =.004)。传感器手术手套引入手术工作流程是可行的,不会影响任务执行。
我们展示了一种新颖且可扩展的技术,可用于检测神经外科手术中的力。力分析可以提供实时数据,以优化术中组织力,降低组织损伤风险,并提供培训和评估的客观指标。