Tactile sensor using acoustic reflection for lump detection in laparoscopic surgery

Exploration of the Design of Spiderweb-Inspired Structures for Vibration-Driven Sensing

In the quest to develop large-area soft sensors, we can look to nature for many examples. Spiderwebs show many fascinating properties that we can seek to understand and replicate in order to develop large-area, soft, and deformable sensing structures. Spiders' webs are used not only to capture prey, but also to localize their prey through the vibrations that they feel through their legs. Inspired by spiderwebs, we developed a large-area tactile sensor for localizing contact points through vibration sensing. We hypothesize that the structure of a web can be leveraged to amplify, filter, or otherwise morphologically tune vibrations to improve sensing capabilities. To explore this design space, we created a means of computationally designing and 3D printing web structures. By using vibration sensors mounted on the edges of webs to simulate a spider monitoring vibrations, we show how varying the structural properties affects the localization performance when using vibration sensors and long short-term memory (LSTM)-based neural network classifiers. We seek to explain the classification performance seen in different webs by considering various metrics of information content for different webs and, hence, provide insight into how bio-inspired spiderwebs can be used to assist large-area sensing structures.

Smart laparoscopic grasper integrated with fiber Bragg grating based tactile sensor for real-time force feedback

Minimally invasive surgery, such as laparoscopic surgery, has developed rapidly due to its small wound, less bleeding and quick recovery. However, a lack of force feedback, which leads to tissue damage, is still unsolved. Many sensors have been used to offer force feedback but still limited by their large size, low security and high complexity. Based on the advantages of small size, high sensitivity and immunity to electromagnetic interferences, we propose a tactile sensor integrated with fiber Bragg gratings (FBGs) at the tip of laparoscopic grasper to offer real-time force feedback in the laparoscopic surgery. The tactile sensor shows a force sensitivity of 0.076 nm/N with a repeatable accuracy of 0.118 N. A bench test is conducted in a laparoscopic training box to verify its feasibility. Test results illustrate that gripping force exerted on the laparoscopic grasper in terms of peak and standard deviation values reduce significantly for the novice subjects with force feedback compared to those without force feedback. The proposed sensor integrated at the tip of the laparoscopic grasper demonstrates a better control of the gripping force among the novice surgeons and indicates that the smart grasper can help surgeons achieve precise gripping force to reduce unnecessary tissue trauma.

A tactile sensor using the acoustic reflection principle for assessing the contact force component in laparoscopic tumor localization

PURPOSE

Localization of an early stage gastric tumor is easily performed in conventional open surgery, whereas it is a difficult procedure in minimally invasive surgery (MIS). A tactile sensor could allow precise resection of the tumor in laparoscopic surgery. The safety of medical tools should be ensured in MIS. Moreover, boundary conditions such as a double-ended beam without a supporting rigid base during tissue palpation were hardly considered. Thus, we suppose that it is informative to assess the normal force and shear force for practical tumor detection considering the boundary condition.

METHODS

In this study, a tactile sensor with normal and shear force measurement functions using the acoustic reflection principle was developed for gastric tumor detection in MIS. The developed tactile sensor was tested using an artificial phantom of the stomach without a supporting rigid base to evaluate the force response of the sensor in intraoperative tumor localization.

RESULTS

The developed sensor is safe for human tissue and can be sterilized. The experimental results show that the developed tactile sensor has the capability to measure normal and shear forces. In the gastric tumor detection test, the shear force of the sensor was more stable and highly responsive to the tumor position than the normal force, which is greatly affected by the bending of the tissue during the operation.

CONCLUSIONS

A two-axis tactile sensor using the acoustic reflection principle was assembled for tissue palpation in MIS. The results showed that the developed sensor is suitable for tumor detection, indicating that the shear force information of the developed sensor is more useful in MIS for early stage gastric tumor localization.

Softness sensing probe with multiple acoustic paths for laparoscopic surgery

PURPOSE

Surgeon's tactile sense is restricted during laparoscopic surgery. We aim to develop a softness sensing probe for endometriosis. Identification of the boundary of the lesion through a tactile sensor during laparoscopic surgery can provide an appropriate cut line, reducing excessive cut.

METHOD

We expand our acoustic reflection-based sensing to the proposed probe, which has three force-sensing points to measure the softness of the object. The compensation of the sensor posture with the three sensor outputs was additionally proposed. This sensor has a simple structure and no electrical elements in the part inserted into the body. The sensing principle was verified using the theoretical analysis. Fundamental experiment to make the estimation model and evaluation test with the simulated environment were conducted.

RESULT

The fundamental experiment showed that different softness can be estimated and that leave-one-out cross-validation resulted that the root-mean-square-error of the softness estimation was 31.5 kPa within the range of 7.5° in the probe posture. Samples which have similar softness as normal and lesioned uterus were used for the evaluation test using laparoscopic box trainer and a general trocar. Six participants operated the sensor, and the results showed that the samples were significantly discriminated by the softness estimated.

CONCLUSION

The experimental results showed that the sensor can estimate the softness while compensating the posture and discriminate model samples of normal and lesioned uterus in the simulated environment, indicating the possibility of boundary identification between normal and lesioned tissues during laparoscopic surgery of endometriosis.

An Acquaintance with An Aging Society

Low birth rates and higher life expectancy have been ravaging Japanese society. This article summarizes some of the latest medical knowledge and assistive activities, with a nod toward one nonprofit organization’s efforts to deliver better home healthcare to the elderly through housing and technologies, in the world’s first super-aging society. The response to the transforming society requires a combination of familiar customs and new technologies that create a favorable environment for mobility and continuous learning that are key to elderly health. As other countries will face similar issues, further international interdisciplinary knowledge-building will be necessary to face the challenges of super-aging societies.

A Pneumatic Tactile Ring for Instantaneous Sensory Feedback in Laparoscopic Tumor Localization

We aim to achieve intraoperative localization of an early-stage gastric tumor that cannot be visually detected during laparoscopic surgery. In this study, we developed and evaluated a pneumatic tactile ring, which is a clinically applicable tactile device to provide instantaneous feedback from a tactile sensor directly manipulated by a surgeon. It was designed to be worn on the finger of the manipulating hand and to present pressure to the finger pad. It is lightweight, cost-effective, disposable, and sterilizable. We also developed a compact pneumatic drive unit to control the pressure and investigated its fundamental performance. The bandwidth of the pressure control was at least 1.3 Hz with a controllable range of up to 79.7 kPa. Moreover, a psychophysical experiment was performed to obtain the Weber ratio of the pressure and evaluate the effectiveness of the instantaneous tactile feedback of the sensor output through the tactile ring. The Weber ratio was 0.40 at the reference pressure of 22.7 kPa. The provided tactile feedback significantly reduced the absolute localization error and increased participants' confidence in their answers. It was shown that the tactile feedback through the ring is effective in laparoscopic tumor localization.

DNN-Based Assistant in Laparoscopic Computer-Aided Palpation

Tactile sensory input of surgeons is severely limited in minimally invasive surgery, therefore manual palpation cannot be performed for intraoperative tumor detection. Computer-aided palpation, in which tactile information is acquired by devices and relayed to the surgeon, is one solution for overcoming this limitation. An important design factor is the method by which the acquired information is fed back to the surgeon. However, currently there is no systematic method for achieving this aim, and it is possible that a badly implemented feedback mechanism could adversely affect the performance of the surgeon. In this study, we propose an assistance algorithm for intraoperative tumor detection in laparoscopic surgery. Our scenario is that the surgeon manipulates a sensor probe, makes a decision based on the feedback provided from the sensor, while simultaneously, the algorithm analyzes the time series of the sensor output. Thus, the algorithm assists the surgeon in making decisions by providing independent detection results. A deep neural network model with three hidden layers was used to analyze the sensor output. We propose methods to input the time series of the sensor output to the model for real-time analysis, and to determine the criterion for detection by the model. This study aims to validate the feasibility of the algorithm by using data acquired in our previous psychophysical experiment. There, novice participants were asked to detect a phantom of an early-stage gastric tumor through visual feedback from the tactile sensor. In addition to the analysis of the accuracy, signal detection theory was employed to assess the potential detection performance of the model. The detection performance was compared with that of human participants. We conducted two types of validation, and found that the detection performance of the model was not significantly different from that of the human participants if the data from a known user was included in the model construction. The result supports the feasibility of the proposed algorithm for detection assistance in computer-aided palpation.

Grasper having tactile sensing function using acoustic reflection for laparoscopic surgery

PURPOSE

In current minimally invasive surgery techniques, the tactile information available to the surgeon is limited. Improving tactile sensation could enhance the operability of surgical instruments. Considering surgical applications, requirements such as having electrical safety, a simple structure, and sterilization capability should be considered. The current study sought to develop a grasper that can measure grasping force at the tip, based on a previously proposed tactile sensing method using acoustic reflection. This method can satisfy the requirements for surgical applications because it has no electrical element within the part that is inserted into the patient's body.

METHODS

We integrated our acoustic tactile sensing method into a conventional grasping forceps instrument. We designed the instrument so that acoustic cavities within a grasping arm and a fork sleeve were connected by a small cavity in a pivoting joint. In this design, when the angle between the two grasping arms changes during grasping, the total length and local curvature of the acoustic cavity remain unchanged. Thus, the grasping force can be measured regardless of the orientation of the grasping arm.

RESULTS

We developed a prototype sensorized grasper based on our proposed design. Fundamental tests revealed that sensor output increased with increasing contact force applied to the grasping arm, and the angle of the grasping arm did not significantly affect the sensor output. Moreover, the results of a grasping test, in which objects with different softness characteristics were held by the grasper, revealed that the grasping force could be appropriately adjusted to handle different objects on the basis of sensor output.

CONCLUSIONS

Experimental results demonstrated that the prototype grasper can measure grasping force, enabling safe and stable grasping.