Can surgeon's hand be replaced with a smart surgical instrument in esophagectomy?
Esophageal cancer is the eighth most common cancer in the world. The most common surgical procedures for esophageal cancer are transhiatal esophagectomy and transthoracic esophagectomy. Thoracic esophagectomy involves an abdominal incision and a thoracotomy, but transhiatal esophagectomy involves both an abdominal incision and a cervical incision. It can reduce postoperative morbidities and fast recovery. In transhiatal esophagectomy, part of dissection is blind and lack of sufficient vision during operation increases the dangers of this kind of surgery. In this paper, we propose a hypothesis about replacing surgeon's hand with surgical instrument in esophagectomy. The proposed instrument is one-forth of surgeon's hand volume and it can surround the esophagus radially. So, it would be able to sheer and dissect all the adhesive tissues around the esophagus. For determining possible threshold of causing traumas in delicate tissues during esophagectomy, various tactile sensors can be incorporated into the surgical instrument to detect and control the contact force of the instrument with delicate biological structures. For evaluating the proposed hypothesis, we analyzed the function of the instrument with finite element method and finally we constructed an initial prototype of the designed instrument.
Farkoush
Siamak Hajizadeh
SH
Artificial Tactile Sensing and Robotic Surgery Lab, Center of Excellence of Biomedical Engineering, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
Najarian
Siamak
S
D016629:Esophagectomy / Q000295:instrumentation*; D020342:Finite Element Analysis; D013502:General Surgery; D006801:Humans; D013525:Surgical Instruments; D000078329:Workforce