title: Employing bending beam transducer design and statistical algorithms to develop a clinical real time tissue compliance mapping system.
abstract: In keyhole surgery, the use of long surgical instruments inserted through small ports in the body diminishes tactile feedback. Earlier methodologies to overcome this challenge never gained popularity in routine clinical practice due to either major modifications to the design of conventional surgical instruments, or relying on surgeons' subjective interpretation of compliance data that is often inaccurate with crossovers. In this paper we present a real time compliance mapping system which comprises of (i) bending beam transducer design to conventional surgical forceps, (ii) statistical analysis for real time objective interpretation of output signals, and (iii) novel human computer interaction techniques suitable for use in the operative theatre working environment. The system was calibrated and put into clinical practice in four routine human keyhole settings. In a research experiment involving 10 surgeons, the system's tissue discriminatory power was three times more sensitive, and 10% less specific than surgeon's hand.
authors.affiliation: Department of Biosurgery and Surgical Technology, St Mary's Hospital, Imperial College London, London, W2 1NY, UK. m.fakhry@imperial.ac.uk
authors.forename: Morkos
authors.initials: M
authors.lastname: Fakhry
authors.forename: Fernando
authors.initials: F
authors.lastname: Bello
authors.forename: George B
authors.initials: GB
authors.lastname: Hanna
mesh_terms: D000465:Algorithms; D001696:Biomechanical Phenomena / Q000295:instrumentation / Q000379:methods; D003198:Computer Simulation; D017076:Computer-Aided Design; D003238:Connective Tissue / Q000502:physiology*; D004548:Elasticity; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005246:Feedback; D006245:Hardness Tests / Q000295:instrumentation* / Q000379:methods; D008954:Models, Biological; D015233:Models, Statistical; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D013525:Surgical Instruments; D014159:Transducers; D014584:User-Computer Interface