| Currently there is no reliable and efficient clinical protocol to intraoperatively assess surgical margins during radical prostatectomy (RP). The objective of this study is to demonstrate feasibility of near real-time intraoperative surgical margin assessment during a Robot Assisted Laparoscopic Prostatectomy (RALP) procedure using a drop-in endoscopic electrical impedance sensing probe.;This thesis focuses primarily on design, evaluation, and construction of an optimized endoscopic probe that can be deployed through a 12 mm diameter laparoscopic port positioned during a RALP procedure. The technology is evaluated through two ex-vivo studies and one in-vivo study of patients undergoing a RALP procedure. Two main techniques analyzed during this study are: Electrical Impedance Spectroscopy (EIS) and Electrical Impedance Tomography (EIT). Significant benign to malignant contrasts were observed for ex-vivo study. Both EIS and EIT show good predictive performance of 0.76 and 0.80 area-under-curve (AUC), respectively, when considering discrete frequencies only. A machine learning algorithm is implemented to combine features, which improves the AUCs of EIS and EIT to 0.83 and 0.85, respectively. Finally, in-vivo data collected from patients undergoing RALP procedures from the two anatomical locations on the prostate and two surrounding peri-prostatic regions demonstrate clinical feasibility of using bio-impedance within a clinical setting. In summary, the significant benign to malignant contrasts observed ex-vivo and the successful use of this probe intraoperatively to collect impedance data suggests the feasibility of deploying this technology to provide surgeons with real-time information regarding the pathological state of margins during RP. This work provides a path for a larger follow-up clinical study. |
