Finger-attachment device for the feedback of gripping and pulling force in a manipulating system for brain tumor resection

Evolution of Robotics in Neurosurgery

Technology and neurosurgery have gone hand in hand since a long time. Technological development of robotics in neurosurgery over the last couple of decades has been rapid, yet it still has a long way to go before it becomes a "routine" element of the standard neurosurgical procedure. Apart from the obvious advantages they have over humans, that is, precision, consistency, endurance, and reproducibility, robots also provide additional freedom of movement beyond what is anatomically feasible for humans. Since its first practical application in 1985, the promise of robotics has spurred development and design of numerous such devices for application in neurosurgery. In the current era, the role of robots in neurosurgery is limited to programming movements and planning trajectories for deep cranial targets, biopsies, spinal screw placements, deep brain stimulation, and stereotactic radiosurgery. This narrative, nonsystematic review discusses the evolution of various robotic systems, with a focus on their neurosurgical applications.

New device with force sensors for laparoscopic liver resection - investigation of grip force and histological damage

Introduction: As the benefits of minimally invasive surgery are recognized, the rate of laparoscopic liver resection (LLR) is rapidly increasing. Liver tissue is fragile compared to tissue of the stomach and colon. In endoscopic and robotic surgery, sufficient tactile sensation is yet to be obtained. Therefore, it is necessary to measure and indicate the grip force of forceps during surgery. We developed a new device consisting of force sensors and investigated its grip force and the resulting histological damage to liver tissue.Material and methods: We measured the grip force generated during laparoscopic surgery in pigs using the forceps with pressure sensors developed by us. Throughout the hepatectomy, we measured the grip force generated by the forceps in real time. We investigated the histological damage to the liver caused by using the forceps with different grip forces.Results: The subject produced a mean grip force of 1.75 N during the procedures. The maximum grip force was 3.38 N. By grasping the tissues of the liver with forceps, bleeding and destruction of the hepatic lobules were observed in a manner dependent on increasing grip force.Conclusion: The new device is necessary for preventing liver damage in laparoscopic hepatic resection.

Method for the Detection of Tumor Blood Vessels in Neurosurgery Using a Gripping Force Feedback System

Avoiding unnecessary bleeding during neuroendoscopic surgeries is crucial because achieving hemostasis in a narrow operating space is challenging. However, when the location of a blood vessel in a tumor cannot be visually confirmed, unintentional damage to the vessel and subsequent bleeding may occur. This study proposes a method for tumor blood vessel detection using a master-slave surgical robot system equipped with a force sensor in the slave gripper. Using this method, blood pulsation inside a tumor was detected, displayed as a gripping force wave, via the slave force sensor. The characteristics of gripping force due to blood pulsation were extracted by measuring the fluctuation of the force in real time. The presence or absence of blood vessels was determined on the basis of cross-correlation coefficients between the gripping force fluctuation waveform due to blood pulsation and model fluctuation waveform. Experimental validation using two types of simulated tumors (soft: E = 6 kPa; hard: E = 38 kPa) and a simulated blood vessel (E = 1.9 MPa, radius = 0.5 mm, thickness = 0.1 mm) revealed that the presence of blood vessels could be detected while gripping at a constant angle and during transient gripping.