Sensor-Based Automated Detection of Electrosurgical Cautery States

Energy dashboard: post-operative insights into electrosurgical device use

BACKGROUND

This study presents a post-operative energy dashboard to teach surgeons about electrosurgical device use. By analyzing the energy generator, we aim to add new information to the current assessment of surgical skills. This study evaluated how such a dashboard can provide insight into differences in electrosurgery application.

METHODS

A semi-automated methodology for the energy dashboard was developed by acquiring intra-operative energy generator and video data, and computing metrics to compare device use. The energy dashboard quantified the use of the electrosurgical device based on the number of activations (N), the duration of individual activations (s), the total use time (s), and the total applied energy (kJ). The methodology and differences in device use were assessed based on forty-eight fundoplication surgeries performed by three surgeons.

RESULTS

The methodology identified the device activations with an F1-score of 0.95. The comparison between the surgeons showed significant differences in total usage, turn-on count, and amount of applied energy. In addition, the dashboard showed a significant difference in total applied energy (kJ) over the dissections of the gastrohepatic and gastrosplenic ligament.

CONCLUSION

The study showed that energy monitoring can provide insights into application differences. In addition, the pilot study showed that the use of electrosurgical devices can differ significantly between surgeons. A broader application of the energy dashboard can enable a new source of information for surgical skill assessment.

Sensor-Based Measurement Method to Support the Assessment of Robot-Assisted Radiofrequency Ablation

Digital surgery technologies, such as interventional robotics and sensor systems, not only improve patient care but also aid in the development and optimization of traditional invasive treatments and methods. Atrial Fibrillation (AF) is the most common cardiac arrhythmia with critical clinical relevance today. Delayed intervention can lead to heart failure, stroke, or sudden cardiac death. Although many advances have been made in the field of radiofrequency (RF) catheter ablation (CA), it can be further developed by incorporating sensor technology to improve its efficacy and safety. Automation can be utilized to shorten the duration of RF ablation, provided that the interactions between the tissue and the RF tools are well understood and adequately modeled. Further research is needed to develop the optimal catheter design. This paper describes the systematic methodology developed to support robot-assisted RF CA characterization measurements. The article describes the custom instruments developed for the experiments, particularly the contact force limiter, the measurement procedure, and the evaluation of the results, as enablers for new results. The aim was to establish an objective, repeatable, robust measurement method and adjacent procedure.