Blood vessel detection, localization and estimation using a smart laparoscopic grasper: a Monte Carlo study

Early Blood Clot Detection Using Forward Scattering Light Measurements Is Not Superior to Delta Pressure Measurements

The occurrence of thrombus formation within an extracorporeal membrane oxygenator is a common complication during extracorporeal membrane oxygenation therapy and can rapidly result in a life-threatening situation due to arterial thromboembolism, causing stroke, pulmonary embolism, and limb ischemia in the patient. The standard clinical practice is to monitor the pressure at the inlet and outlet of oxygenators, indicating fulminant, obstructive clot formation indicated by an increasing pressure difference (ΔP). However, smaller blood clots at early stages are not detectable. Therefore, there is an unmet need for sensors that can detect blood clots at an early stage to minimize the associated thromboembolic risks for patients. This study aimed to evaluate if forward scattered light (FSL) measurements can be used for early blood clot detection and if it is superior to the current clinical gold standard (pressure measurements). A miniaturized in vitro test circuit, including a custom-made test chamber, was used. Heparinized human whole blood was circulated through the test circuit until clot formation occurred. Four LEDs and four photodiodes were placed along the sidewall of the test chamber in different positions for FSL measurements. The pressure monitor was connected to the inlet and the outlet to detect changes in ΔP across the test chamber. Despite several modifications in the LED positions on the test chamber, the FSL measurements could not reliably detect a blood clot within the in vitro test circuit, although the pressure measurements used as the current clinical gold standard detected fulminant clot formation in 11 independent experiments.

Noninvasive Flow Monitoring in Simple Flow Phantom Using Resistive Strain Sensors

In this paper, we introduce a monitoring method for flow expansion and contraction in a simple flow phantom based on electrical resistance changes in an epidermal strain sensor attached to the phantom. The flow phantom was fabricated to have a nonflat surface and small modulus that are analogous to human skin. The epidermal sensors made of polydopamine and polyvinyl alcohol show sufficient linearity (R = 0.9969), reproducibility, and self-adhesion properties, as well as high sensitivity to small modulus measurements (<1% tensile strain). Pulsatile flow monitoring experiments were performed by placing the epidermal sensor on the flow phantom and measuring the relative changes in resistance by the heartbeat. Experiments were conducted for three types of vessel diameters (1.5, 2, and 3 mm). In each of the experiments, the vessels were divided into Top, Middle, and Bottom positions. Experiments for each position show that the relative changes in resistance increase proportionally with the diameter of the vessel. The vessels located close to the epidermal layer have greater relative electrical changes. The results were analyzed using the Bernoulli equation and hoop stress formula. This study demonstrates the feasibility of a noninvasive flow monitoring method using a novel resistive strain sensor.

Laparoscopic diffuse reflectance spectroscopy of an underlying tubular inclusion: a phantom study

We demonstrate diffuse reflectance spectroscopy (DRS) of a subsurface tubular inclusion by using a fiber probe having a single source-detector pair attached to a laparoscopic bipolar device. A forward model was also developed for DRS sensing of an underlying long absorbing tubular inclusion set in parallel to the tissue surface, normal to the line of sight of the source-detector pair, and equidistant from the source and the detector. The model agreed with measurements performed at 500 nm and using a 10 mm source-detector separation (SDS) on an aqueous tissue phantom embedding a tubing of 2 or 4 mm inner diameter that contained 9.1% to 33.3% red dye at a depth of up to 11.5 mm. When tested on solid phantoms using the 10 mm SDS, a tubular inclusion of $ \ge 3\;{\rm mm}$≥3mm inner diameter containing 0.05% red dye at a background absorption coefficient of $ 0.021\;{\rm mm}^{-1} $0.021mm^-1 caused $ \ge 8\% $≥8% change of the signal at 500 nm versus the baseline when the inclusion was shallower than 5 mm. When assessed on avian muscle tissue having a 4 mm tubular inclusion embedded at an edge depth of 2 mm, DRS with the 10 mm SDS differentiated the following contents of the inclusion: 33.3% red dye (mimicking blood), 33.3% green dye, 33.3% yellow dye (mimicking bile), water (mimicking urine), and air.

Method for the Detection of Tumor Blood Vessels in Neurosurgery Using a Gripping Force Feedback System

Avoiding unnecessary bleeding during neuroendoscopic surgeries is crucial because achieving hemostasis in a narrow operating space is challenging. However, when the location of a blood vessel in a tumor cannot be visually confirmed, unintentional damage to the vessel and subsequent bleeding may occur. This study proposes a method for tumor blood vessel detection using a master-slave surgical robot system equipped with a force sensor in the slave gripper. Using this method, blood pulsation inside a tumor was detected, displayed as a gripping force wave, via the slave force sensor. The characteristics of gripping force due to blood pulsation were extracted by measuring the fluctuation of the force in real time. The presence or absence of blood vessels was determined on the basis of cross-correlation coefficients between the gripping force fluctuation waveform due to blood pulsation and model fluctuation waveform. Experimental validation using two types of simulated tumors (soft: E = 6 kPa; hard: E = 38 kPa) and a simulated blood vessel (E = 1.9 MPa, radius = 0.5 mm, thickness = 0.1 mm) revealed that the presence of blood vessels could be detected while gripping at a constant angle and during transient gripping.