IEEE Trans Biomed Eng. 2024 Jun;71(6):1958-1968. doi: 10.1109/TBME.2024.3357293. Epub 2024 May 20.
OBJECTIVE: Robot-assisted minimally invasive surgery remains limited by the absence of haptic feedback, which surgeons routinely rely on to assess tissue stiffness. This limitation hinders surgeons' ability to identify and treat abnormal tissues, such as tumors, during robotic surgery. METHODS: To address this challenge, we developed a robotic tissue palpation device capable of rapidly and non-invasively quantifying the stiffness of soft tissues, allowing surgeons to make objective and data-driven decisions during minimally invasive procedures. We evaluated the effectiveness of our device by measuring the stiffness of phantoms as well as lung, heart, liver, and skin tissues obtained from both rats and swine. RESULTS: Results demonstrated that our device can accurately determine tissue stiffness and identify tumor mimics. Specifically, in swine lung, we determined elastic modulus (E) values of 9.1 ± 2.3, 16.8 ± 1.8, and 26.0 ± 3.6 kPa under different internal pressure of the lungs (PIP) of 2, 25, and 45 cmHO, respectively. Using our device, we successfully located a 2-cm tumor mimic embedded at a depth of 5 mm in the lung subpleural region. Additionally, we measured E values of 33.0 ± 5.4, 19.2 ± 2.2, 33.5 ± 8.2, and 22.6 ± 6.0 kPa for swine heart, liver, abdominal skin, and muscle, respectively, which closely matched existing literature data. CONCLUSION/SIGNIFICANCE: Results suggest that our robotic palpation device can be utilized during surgery, either as a stand-alone or additional tool integrated into existing robotic surgical systems, to enhance treatment outcomes by enabling accurate intraoperative identification of abnormal tissue.
目的:机器人辅助微创手术仍然受到缺乏触觉反馈的限制,而外科医生通常依赖触觉反馈来评估组织的硬度。这种限制阻碍了外科医生在机器人手术中识别和治疗异常组织(如肿瘤)的能力。
方法:为了解决这一挑战,我们开发了一种机器人组织触诊设备,能够快速、非侵入性地量化软组织的硬度,使外科医生能够在微创手术过程中做出客观和数据驱动的决策。我们通过测量人工模拟物以及从大鼠和猪获得的肺、心脏、肝脏和皮肤组织的硬度来评估我们设备的有效性。
结果:结果表明,我们的设备可以准确地确定组织的硬度并识别肿瘤模拟物。具体来说,在猪的肺中,我们在不同的肺内压(PIP)为 2、25 和 45 cmHO 下分别确定了 9.1 ± 2.3、16.8 ± 1.8 和 26.0 ± 3.6 kPa 的弹性模量(E)值。使用我们的设备,我们成功地定位了在肺胸膜下区域深度为 5 毫米处嵌入的 2 厘米肿瘤模拟物。此外,我们测量了猪心脏、肝脏、腹部皮肤和肌肉的 E 值分别为 33.0 ± 5.4、19.2 ± 2.2、33.5 ± 8.2 和 22.6 ± 6.0 kPa,与现有文献数据非常匹配。
结论/意义:结果表明,我们的机器人触诊设备可以在手术中使用,无论是作为独立的工具还是集成到现有的机器人手术系统中的附加工具,都可以通过在术中准确识别异常组织来提高治疗效果。
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