title: Forces exerted during microneurosurgery: a cadaver study.
abstract: BACKGROUND
  A prerequisite for the successful design and use of robots in neurosurgery is knowledge of the forces exerted by surgeons during neurosurgical procedures. The aim of the present cadaver study was to measure the surgical instrument forces exerted during microneurosurgery.
  
  
  METHODS
  An experimental apparatus was set up consisting of a platform for human cadaver brains, a Leica microscope to provide illumination and magnification, and a Quanser 6 Degrees-Of-Freedom Telepresence System for tissue manipulation and force measurements.
  
  
  RESULTS
  The measured forces varied significantly depending on the region of the brain (P = 0.016) and the maneuver performed (P < 0.0001). Moreover, blunt arachnoid dissection was associated with greater force exertion than sharp dissection (0.22 N vs. 0.03 N; P = 0.001).
  
  
  CONCLUSIONS
  The forces necessary to manipulate brain tissue were surprisingly low and varied depending on the anatomical structure being manipulated, and the maneuver performed. Knowledge of such forces could well increase the safety of microsurgery.
authors.affiliation: Hamlyn Centre, Imperial College London, London, UK; Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.
authors.forename: Hani J
authors.initials: HJ
authors.lastname: Marcus
authors.forename: Kourosh
authors.initials: K
authors.lastname: Zareinia
authors.forename: Liu Shi
authors.initials: LS
authors.lastname: Gan
authors.forename: Fang Wei
authors.initials: FW
authors.lastname: Yang
authors.forename: Sanju
authors.initials: S
authors.lastname: Lama
authors.forename: Guang-Zhong
authors.initials: GZ
authors.lastname: Yang
authors.forename: Garnette R
authors.initials: GR
authors.lastname: Sutherland
mesh_terms: D001696:Biomechanical Phenomena; D001921:Brain / Q000601:surgery; D002102:Cadaver; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008953:Models, Anatomic; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*
keywords: force; microsurgery; neurosurgery; robotics