In-Vivo and Postmortem Compressive Properties of Porcine Abdominal Organs

Real-Time Measurement of the Tool-Tissue Interaction in Minimally Invasive Abdominal Surgery: The First Step to Developing the Next Generation of Smart Laparoscopic Instruments

Introduction Analysis of force application in laparoscopic surgery is critical to understanding the nature of the tool-tissue interaction. The aim of this study is to provide real-time data about manipulations to abdominal organs. Methods An instrumented short fenestrated grasper was used in an in vivo porcine model, measuring force at the grasper handle. Grasping force and duration over 5 small bowel manipulation tasks were analyzed. Forces required to retract gallbladder, bladder, small bowel, large bowel, and rectum were measured over 30 seconds. Four parameters were calculated-T(hold), the grasp time; T(close), time taken for the jaws to close; F(max), maximum force reached; and F(rms), root mean square force (representing the average force across the grasp time). Results Mean F(max) to manipulate the small bowel was 20.5 N (±7.2) and F(rms) was 13.7 N (±5.4). Mean T(close) was 0.52 seconds (±0.26) and T(hold) was 3.87 seconds (±1.5). In individual organs, mean F(max) was 49 N (±15) to manipulate the rectum and 59 N (±13.4) for the colon. The mean F(max) for bladder and gallbladder retraction was 28.8 N (±7.4) and 50.7 N (±3.8), respectively. All organs exhibited force relaxation, the F(rms) reduced to below 25 N for all organs except the small bowel, with a mean F(rms) of less than 10 N. Conclusion This study has commenced the process of quantifying tool-tissue interaction. The static measurements discussed here should evolve to include dynamic measurements such as shear, torque, and retraction forces, and be correlated with evidence of histological damage to tissue.

Strain rate-dependent viscohyperelastic constitutive modeling of bovine liver tissue

The mechanical response of most soft tissue is considered to be viscohyperelastic, making the development of accurate constitutive models a challenging task. In this article, we present a constitutive model for bovine liver tissue that utilizes a viscous dissipation potential, and use it to model the response of bovine liver tissue at strain rates ranging from 0.001 to 0.04 s(-1). On the material modeling front of this study, the free energy is assumed to depend on the right Cauchy-Green deformation tensor, whereas a separate rate-dependent viscous potential is posited to characterize viscoelasticity. This viscous dissipation component is a function of the time rate of change of the right Cauchy-Green deformation tensor. On the experimental front, no-slip uniaxial compression experiments are conducted on bovine liver tissue at various strain rates. A numerical correction approach is used to account for the no-slip edge conditions, and the constitutive model is fit to the resulting corrected stress-strain data. The complete derivation of the material model, its implementation in the finite element software package ABAQUS, and a validation study are presented in this article. The results show that bovine liver tissue exhibits a strong strain-rate dependence even at the low strain rates considered here and that the proposed constitutive model is able to accurately describe this response.

Biomechanical behaviour of oesophageal tissues: material and structural configuration, experimental data and constitutive analysis

The aim of the present work is to propose an approach to the biomechanical analysis of oesophagus by defining an appropriate constitutive model and the associated constitutive parameters. The configuration of the different tissues and layers that compose the oesophagus shows very complicated internal anatomy, geometry and mechanical properties. The coupling of these tissues adds to the complexity. The constitutive models must be capable of interpreting the highly non-linear mechanical response. This is done adopting a specific hyperelastic anisotropic formulation. Experimental data are essential for the investigation of the tissues' biomechanical behaviour and also represent the basis for the definition of constitutive parameters to be adopted within the constitutive formulation developed. This action is provided by using a specific stochastic optimization procedure, addressed to the minimization of a cost function that interprets the discrepancy between experimental data and results from the analytical models developed. Unfortunately, experimental data at disposal do not satisfy all requested information and a particular solution must be provided with regard to definition of the lateral contraction of soft tissues. The anisotropic properties of the tissues are investigated considering the configuration of embedded fibres, according to their mechanical characteristics, quantity and distribution. Collagen and muscular fibres must be considered. The formulation provided on the basis of axiomatic theory of constitutive relationships and the procedure for constitutive parameters identification are described. The evaluation of constitutive parameters requires the analysis of data from experimental tests, that are extracted from the literature. Result validation is performed by comparing the experimental data and model results. In this way a valid basis is provided for the investigation of biomechanical behaviour of oesophagus, looking at deeper information from the experimental point of view that should offer data to be implemented in the procedure for a more detailed and accurate problem definition.

A micro-tactile sensor for in situ tissue characterization in minimally invasive surgery

This study presents and characterizes a micro-tactile sensor that can be integrated within MIS graspers. The sensor is capable of measuring contact forces and characterizing softness. The grasping forces are distributed normally, though in some cases concentrated loads also appear at the contact surfaces. In the latter case, the position of the concentric load can also be determined. This enables the sensor to detect hidden anatomical features such as embedded lumps or arteries. The microfabricated piezoelectric-based sensor was modeled both analytically and numerically. In a parametric study the influence of parameters such as length, width, and thickness of the sensor was studied using a finite element model. The sensor was microfabricated and tested using elastomeric samples. There is a good conformity between the experimental and theoretical results.

Biomechanical Properties of Abdominal Organs In Vivo and Postmortem Under Compression Loads

Accurate knowledge of biomechanical characteristics of tissues is essential for developing realistic computer-based surgical simulators incorporating haptic feedback, as well as for the design of surgical robots and tools. As simulation technologies continue to be capable of modeling more complex behavior, an in vivo tissue property database is needed. Most past and current biomechanical research is focused on soft and hard anatomical structures that are subject to physiological loading, testing the organs in situ. Internal organs are different in that respect since they are not subject to extensive loads as part of their regular physiological function. However, during surgery, a different set of loading conditions are imposed on these organs as a result of the interaction with the surgical tools. Following previous research studying the kinematics and dynamics of tool/tissue interaction in real surgical procedures, the focus of the current study was to obtain the structural biomechanical properties (engineering stress-strain and stress relaxation) of seven abdominal organs, including bladder, gallbladder, large and small intestines, liver, spleen, and stomach, using a porcine animal model. The organs were tested in vivo, in situ, and ex corpus (the latter two conditions being postmortem) under cyclical and step strain compressions using a motorized endoscopic grasper and a universal-testing machine. The tissues were tested with the same loading conditions commonly applied by surgeons during minimally invasive surgical procedures. Phenomenological models were developed for the various organs, testing conditions, and experimental devices. A property database—unique to the literature—has been created that contains the average elastic and relaxation model parameters measured for these tissues in vivo and postmortem. The results quantitatively indicate the significant differences between tissue properties measured in vivo and postmortem. A quantitative understanding of how the unconditioned tissue properties and model parameters are influenced by time postmortem and loading condition has been obtained. The results provide the material property foundations for developing science-based haptic surgical simulators, as well as surgical tools for manual and robotic systems.

Effects of perfusion on the viscoelastic characteristics of liver

Accurate characterization of soft tissue material properties is required to enable new computer-aided medical technologies such as surgical training and planning. The current means of acquiring these properties in the in vivo and ex vivo states is fraught with problems, including limited accessibility and unknown boundary conditions in the former, and unnatural behavior in the latter. This paper presents a new testing method where a whole porcine liver is perfused under physiologic conditions and tested in an ex vivo setting. To characterize the effects of perfusion on the viscoelastic response of liver, indentation devices made force and displacement measurements across four conditions: in vivo, ex vivo perfused, ex vivo post perfused, and in vitro on an excised section. One device imposed cyclic perturbations on the liver's surface, inducing nominal strains up to 5% at frequencies from 0.1 to 200 Hz. The other device measured 300 s of the organ's creep response to applied loads, inducing nominal surface stresses of 6.9-34.7 kPa and nominal strains up to 50%. Results from empirical models indicate that the viscoelastic properties of liver change with perfusion and that two time constants on the order of 1.86 and 51.3s can characterize the liver under large strains typical of surgical manipulation across time periods up to 300 s. Unperfused conditions were stiffer and more viscous than the in vivo state, resulting in permanent strain deformation with repeated indentations. Conversely, the responses from the ex vivo perfusion condition closely approximated the in vivo response.