title: Quantification of Forces During a Neurosurgical Procedure: A Pilot Study.
abstract: OBJECTIVE
  Knowledge of tool-tissue interaction is mostly taught and learned in a qualitative manner because a means to quantify the technical aspects of neurosurgery is currently lacking. Neurosurgeons typically require years of hands-on experience, together with multiple initial trial and error, to master the optimal force needed during the performance of neurosurgical tasks. The aim of this pilot study was to develop a novel force-sensing bipolar forceps for neurosurgery and obtain preliminary data on specific tasks performed on cadaveric brains.
  
  
  METHODS
  A novel force-sensing bipolar forceps capable of measuring coagulation and dissection forces was designed and developed by installing strain gauges along the length of the bipolar forceps prongs. The forceps was used in 3 cadaveric brain experiments and forces applied by an experienced neurosurgeon for 10 surgical tasks across the 3 experiments were quantified.
  
  
  RESULTS
  Maximal peak (effective) forces of 1.35 N and 1.16 N were observed for dissection (opening) and coagulation (closing) tasks, respectively. More than 70% of forces applied during the neurosurgical tasks were less than 0.3 N. Mean peak forces ranged between 0.10 N and 0.41 N for coagulation of scalp vessels and pia-arachnoid, respectively, and varied from 0.16 N for dissection of small cortical vessel to 0.65 N for dissection of the optic chiasm.
  
  
  CONCLUSIONS
  The force-sensing bipolar forceps were able to successfully measure and record real-time tool-tissue interaction throughout the 3 experiments. This pilot study serves as a first step toward quantification of tool-tissue interaction forces in neurosurgery for training and improvement of instrument handling skills.
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors: Liu Shi
authors: LS
authors: Gan
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors: Kourosh
authors: K
authors: Zareinia
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors: Sanju
authors: S
authors: Lama
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors: Yaser
authors: Y
authors: Maddahi
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors: Fang Wei
authors: FW
authors: Yang
authors: Project NeuroArm, Department of Clinical Neuroscience and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Electronic address: garnette@ucalgary.ca.
authors: Garnette R
authors: GR
authors: Sutherland
mesh_terms: D001696:Biomechanical Phenomena; D001921:Brain / Q000601:surgery*; D002983:Clinical Competence; D004210:Dissection / Q000193:education / Q000295:instrumentation / Q000379:methods; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D019635:Neurosurgical Procedures / Q000193:education / Q000295:instrumentation* / Q000379:methods*; D010865:Pilot Projects; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D013525:Surgical Instruments; D014160:Transducers, Pressure
keywords: Bipolar forceps; Coagulation; Dissection; Neurosurgery; Sensors; Tool-tissue interaction forces