Finite element analysis for evaluating liver tissue damage due to mechanical compression

Mechanical properties of human hepatic tissues to develop liver-mimicking phantoms for medical applications

Using liver phantoms for mimicking human tissue in clinical training, disease diagnosis, and treatment planning is a common practice. The fabrication material of the liver phantom should exhibit mechanical properties similar to those of the real liver organ in the human body. This tissue-equivalent material is essential for qualitative and quantitative investigation of the liver mechanisms in producing nutrients, excretion of waste metabolites, and tissue deformity at mechanical stimulus. This paper reviews the mechanical properties of human hepatic tissues to develop liver-mimicking phantoms. These properties include viscosity, elasticity, acoustic impedance, sound speed, and attenuation. The advantages and disadvantages of the most common fabrication materials for developing liver tissue-mimicking phantoms are also highlighted. Such phantoms will give a better insight into the real tissue damage during the disease progression and preservation for transplantation. The liver tissue-mimicking phantom will raise the quality assurance of patient diagnostic and treatment precision and offer a definitive clinical trial data collection.

Tissue stress from laparoscopic grasper use and bowel injury in humans: establishing intraoperative force boundaries

Objectives

We aim to determine what threshold of compressive stress small bowel and colon tissues display evidence of significant tissue trauma during laparoscopic surgery.

Design

This study included 10 small bowel and 10 colon samples from patients undergoing routine gastrointestinal surgery. Each sample was compressed with pressures ranging from 100 kPa to 600 kPa. Two pathologists who were blinded to all study conditions, performed a histological analysis of the tissues. Experimentation: November 2018–February 2019. Analysis: March 2019–May 2020.

Setting

An inner-city trauma and ambulatory hospital with a 40-bed inpatient general surgery unit with a diverse patient population.

Participants

Patients were eligible if their surgery procured healthy tissue margins for experimentation (a convenience sample). 26 patient samples were procured; 6 samples were unusable. 10 colon and 10 small bowel samples were tested for a total of 120 experimental cases. No patients withdrew their consent.

Interventions

A novel device was created to induce compressive “grasps” to simulate those of a laparoscopic grasper. Experimentation was performed ex-vivo, in-vitro. Grasp conditions of 0–600 kPa for a duration of 10 s were used.

Results

Small bowel (10), M:F was 7:3, average age was 54.3 years. Colon (10), M:F was 1:1, average age was 65.2 years. All 20 patients experienced a significant difference (p<0.05) in serosal thickness post-compression at both 500 and 600 kPa for both tissue types. A logistic regression analysis with a sensitivity of 100% and a specificity of 84.6% on a test set of data predicts a safety threshold of 329–330 kPa.

Conclusions

A threshold was discovered that corresponded to both significant serosal thickness change and a positive histological trauma score rating. This “force limit” could be used in novel sensorized laparoscopic tools to avoid intraoperative tissue injury.

Evaluating tensile damage of brain tissue in intracerebral hemorrhage based on strain energy

Intracerebral hemorrhage (ICH) may lead to physical and pathological damage and has been a focus of research for decades. Evaluating tensile damage caused by deformation in ICH is an important component of damage assessment for correct diagnosis and treatment. Traditional research on ICH paid little attention to quantified brain tissue damage resulting from mechanical factors, and only a few reported the mechanical properties of damaged brain tissue. The aim of the present study was to present an effective method that is able to evaluate the tissue damage degree in ICH, based on strain energy function. Two finite element analysis (FEA) models were analyzed: A three-dimensional (3D) model for tissue's tension experiment and a two-dimensional (2D) model for brain tissue's deformation in ICH. The polynomial fitting function of stress vs. stretch curve, which was derived from previous reports, was used in the FEA as the constitutive function of brain tissue. The present study demonstrated that white matter could be regarded as hyperelastic material when stretch was <1.343, and with stretch increasing, tissue injury exacerbated when stretch was >1.343. The strain energy loss was not linear in this process, and Neo-Hookean and Ogden model's results demonstrated a similar change in trend, but a difference in quantity. The results from 2D and 3D simulation, respectively, demonstrated the degree of damage according to the above dividing criteria and the possible distribution of tissue damage after ICH ictus. An analytical model from a biomechanical perspective for white matter injury in ICH may facilitate to improve clinical diagnosis and treatment.

The estimation method of friction in unconfined compression tests of liver tissue

In traditional unconfined compression tests, the friction between platform and specimen is often considered negligible or minimized by lubrication or other means. However, friction can affect the estimation of material parameters. The percentage difference in radial deformation was investigated in this study. A novel friction estimation method was established and verified using a finite element method. The proposed method was based on the radial deformation during the compression process. Three different hyperelastic material parameters of liver tissue were applied in the simulations. The hyperelastic parameters H1 were obtained by no-slip compression tests, while the others were extracted from the literature. The results showed that the percentage difference in radial deformation was mainly influenced by the friction coefficient and diameter-to-height ( d/ h) ratio of the specimen in unconfined compression tests. The percentage difference increased as the friction coefficient and d/ h increased. Different d/ h and friction coefficient values were tested to validate the proposed method, and the accuracy was estimated to exceed 86%. An optimization strategy for material parameters in unconfined compression tests was proposed accordingly.

Design of an intraoperative peritoneal lavage device

This paper consists of the design and construction of an intraoperative peritoneal lavage device. It is intended for cleaning the intra-abdominal cavity during a surgical procedure, once the etiology of a peritonitis has been identified and treated. Its purpose is to improve the current standard treatment consisting of simple pouring saline solution. A good washing procedure aids stopping the inflammatory and infectious process generated after the contamination due to the perforation of a hollow viscera. COMSOL Multiphysics software was used to simulate the biomechanical behavior of the liver against localized pressure. A graphical interface allows the user to predict liver deformation under different fluid pressures and positions simulating the lavage procedure. A preliminary prototype was implemented and a clinical trial was approved in an animal model. Three intraperitoneal structures belonging to a sheep were analyzed to observe the effect of the lavage. In closing, the final prototype implemented delivers a maximum force of 0.08 [N] and a pressure of 25.6 [kPa], and complied with the specialist's expectations.