The Value Of FBG-based Force Sensor In Reducing Tissue Damage In Minimally Invasive Surgery

BackgroundMinimally invasive surgery is the mainstream of surgical development in the new era,which is based on clinical medicine and integrates a variety of disciplines to make it more accurate,fine,minimally invasive and multi-information oriented intelligence.However,the lack of tactile feedback in minimally invasive surgery can lead surgeons to apply excessive gripping force,resulting in unnecessary tissue damage and serious intraoperative and postoperative complications.To address the problem of force feedback loss,scholars are exploring the combination of electric force sensors with laparoscopic surgical instruments to establish artificial tactile feedback.Although studies have shown that these instruments can reduce the force applied by surgeons during surgery,their poor biocompatibility and susceptibility to electromagnetic interference have hindered their clinical applications.In previous research,our team successfully developed a laparoscopic grasper integrated with Fiber Bragg Grating(FBG)sensors,which have excellent biocompatibility and anti-electromagnetic interference ability.Testing in a laparoscopic box also demonstrated that this instrument can effectively reduce the force applied by novice laparoscopic surgeons during surgery.This study aims to analyze the gripping force of rabbit small intestine and liver using a laparoscopic grasper integrated with FBG sensors and to establish a safe force threshold during grasping operations through histological analysis.Subsequently,we will explore the potential of force feedback provided by FBG sensors in reducing tissue damage during laparoscopic surgery.ObjectiveTo obtain the force safety threshold of small intestine and liver tissue injury in rabbits,and investigate the potential of using FBG sensors for providing force feedback to minimize tissue damage during laparoscopic surgery.Methods1.The laparoscopic grasping forceps integrated with FBG force sensor was used to perform in vivo clamping experiments on rabbit small intestine and liver tissues through different force gradients,and the overall experimental scene simulated the clamping of tissues and organs in laparoscopic surgery.According to the tissue damage quantitative assessment system,the tissue at the gripping site was histological analyzed to study the relationship between the gripping force and tissue damage,and to clarify the safe threshold range of tissue damage force.2.Nine novice surgeons with no laparoscopic experience were recruited in the following three modes:M1:closed force feedback;M2:opening force feedback;M3:closing force feedback again,continuously complete the three laparoscopic surgical tasks of rabbit small intestine clamping,resection and rabbit liver resection,and quantitatively analyze the tissue damage under different modes through the tissue damage quantitative evaluation system.Results1.With the increasing of clamping force,the degree of tissue injury also increased,and the forms of injury also became diverse.When the clamping force was greater than 2N,the liver tissue of rabbits was obviously damaged(P<0.05).When the clamping force was greater than 2.5N,the small intestine tissue of rabbits was obviously damaged(P<0.05).2.When the force feedback was turned on,the tissue damage caused by the novice surgeon in the three laparoscopic tasks of rabbit small intestine clamping,resection and rabbit liver resection decreased(P<0.05).When the force feedback was turned off,the effect of force reduction and tissue damage reduction was still preserved in the task of rabbit small intestine clamping and resection(P<0.05).Conclusion1.The force safety threshold of rabbit liver tissue injury is 2N,and the force safety threshold of rabbit small intestine tissue injury is 2.5N.The clamping operation under this threshold can avoid excessive tissue damage caused by small intestine and liver tissue,and expand the database information of the safety force threshold of this tissue.2.The laparoscopic grasper with integrated FBG force sensor can provide force stability and force safety threshold feedback for the surgeon to compensate for the lack of haptic feedback,reduce the force applied during laparoscopic surgery,and thereby reduce tissue damage to the rabbit intestine and liver.