title: Evaluation of liver tissue damage and grasp stability using finite element analysis.
abstract: Minimizing tissue damage and maintaining grasp stability are essential considerations in surgical grasper design. Most past and current research analyzing graspers used for tissue manipulation in minimally invasive surgery is based on in vitro experiments. Most previous work assessed tissue injury and grasp security by visual inspection; only a few studies have quantified it. The goal of the present work is to develop a methodology with which to compute tissue damage magnitude and grasp quality that is appropriate for a wide range of grasper-tissue interaction. Using finite element analysis (FEA), four graspers with varying radii of curvature and four graspers with different tooth sizes were analyzed while squeezing and pulling liver tissue. All graspers were treated as surgical steel with linear elastic material properties. Nonlinear material properties of tissue used in the FEA as well as damage evaluation were derived from previously reported in vivo experiments. Computed peak stress, integrated stress, and tissue damage were compared. Applied displacement is vertical and then horizontal to the tissue surface to represent grasp and retraction. A close examination of the contact status of each node within the grasper-tissue interaction surface was carried out to investigate grasp stability. The results indicate less tissue damage with increasing radius of curvature. A smooth wave pattern reduced tissue damage at the cost of inducing higher percentage of slipping area. This methodology may be useful for researchers to develop and test various designs of graspers. Also it could improve surgical simulator performance by reflecting more realistic tissue material properties and predicting tissue damage for the student.
authors.affiliation: a Department of Mechanical Engineering , University of Washington , Box 352600, Seattle , WA 98195 , USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Cheng
authors.affiliation: b Department of Electrical Engineering , University of Washington , Box 352500, Seattle , WA 98195 , USA.
authors.forename: Blake
authors.initials: B
authors.lastname: Hannaford
mesh_terms: D020342:Finite Element Analysis; D017276:Friction; D006801:Humans; D008099:Liver / Q000473:pathology*; D008954:Models, Biological; D009336:Necrosis; D017711:Nonlinear Dynamics; D013314:Stress, Mechanical; D013525:Surgical Instruments
keywords: finite element analysis; grasp stability; liver; minimally invasive surgery; surgical grasper; tissue damage