Derakhshan R, Ahmadian M T
School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
School of Mechanical Engineering, Sharif University of Technology, Center of Excellence in Design, Robotic and Automation, Tehran, Iran.
Heliyon. 2024 Aug 18;10(17):e36454. doi: 10.1016/j.heliyon.2024.e36454. eCollection 2024 Sep 15.
Hepatectomy, or liver resection, is a process by which through surgery part or all of the liver is removed. In this operation, less bleeding, negligible damage and fast removal are the most important requirements. Surgery through waterjet is one of the most efficient techniques which is widely used in hepatectomy. Some clinical studies are conducted to investigate waterjet method in liver resection. In the present study interaction of waterjet with liver during the process of the surgery is investigated in terms of mechanical engineering. For this purpose, a system of waterjet is designed to consider the interaction of waterjet with liver at different nozzle diameter and velocities. For validation, SPH-FEM model is used to analyze waterjet interaction with hyperelastic liver. In this model, liver cutting is simulated using element deletion defined by a subroutine code based on maximum principal strain criterion. Depth of cut along with degraded volume are measured experimentally and compared with simulated method. Results show that good agreement exists between experimental and simulation finding. By comparing depth of cut in the experimental and simulation results, it can be seen that liver behavior changes from brittle to ductile by increasing waterjet velocity during the experimental tests. For the simulation, maximum principal strain threshold is set to be between 0.1 and 0.4. However, the best agreement between experimental and simulation results exists at maximum principal strain threshold equal to 0.2. The findings can help surgeons to find the best working range of waterjet device and the most efficient operation.
肝切除术，即肝脏切除手术，是一种通过外科手术切除部分或全部肝脏的过程。在该手术中，减少出血、最小化损伤以及快速切除是最为重要的要求。水刀手术是肝切除术中广泛应用的最高效技术之一。一些临床研究旨在探究水刀在肝脏切除术中的应用方法。在本研究中，从机械工程学角度对手术过程中水刀与肝脏的相互作用进行了研究。为此，设计了一个水刀系统，以考虑不同喷嘴直径和速度下水刀与肝脏的相互作用。为进行验证，采用光滑粒子流体动力学 - 有限元模型（SPH - FEM）来分析水刀与超弹性肝脏的相互作用。在该模型中，基于最大主应变准则，使用由子程序代码定义的单元删除来模拟肝脏切割。通过实验测量切割深度以及降解体积，并与模拟方法进行比较。结果表明，实验结果与模拟结果吻合良好。通过比较实验和模拟结果中的切割深度可以看出，在实验测试过程中，随着水刀速度的增加，肝脏行为从脆性转变为韧性。对于模拟，最大主应变阈值设定在0.1至0.4之间。然而，当最大主应变阈值等于0.2时，实验结果与模拟结果之间的吻合度最佳。这些研究结果有助于外科医生找到水刀设备的最佳工作范围以及最有效的手术操作方式。
