Engineering Improvements in Surgery: Optimisation of Surgical Graspers

手术中的工程改进：手术抓取器的优化

• 批准号: EP/L022273/1
• 负责人: Peter Culmer
• 金额: $ 12.66万
• 依托单位: University of Leeds
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2014
• 资助国家: 英国
• 起止时间: 2014 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FL022273%2F1
• 关键词: Engineering; Improvements; Surgery; Optimisation; Surgical

*Overview:This research will improve the surgical instruments used in key-hole surgery so that they cause less damage to the patient while helping the surgeon to operate more efficiently. These valuable goals will be achieved through a close partnership between the project's lead engineer and a surgeon, bringing together precise experimental methods, novel materials and design and clinical expertise. The outcomes of this exciting research will help scientists, engineers and clinicians in their research, and has significant potential to bring improvements to society and the economy.*Background:Modern surgery increasingly uses minimally-invasive surgical (MIS) techniques (or 'keyhole surgery'). In MIS the surgeon operates on tissues using a camera and long instruments inserted into the body though small access 'ports'. The advantages of MIS are substantial including faster recovery and lower complications for the patient. However, the long instruments make it difficult for the surgeon to 'feel' the tissues inside the body. This is a particular problem with surgical graspers, plier-like instruments used in place of the surgeon's hand to hold and move tissues. Appropriate use of the graspers is crucial, but difficult, for the surgeon to achieve; grasping or pulling too hard causes tissue damage with potentially fatal consequences for the patient, but grasping too lightly risks the tissue slipping - complicating and lengthening the operation.The applicants lead the Surgical Technologies research group and have a strong background in using engineering techniques to measure and understand the behaviour of surgical instruments and their interaction with tissues. They have supervised research to develop grasper systems with can record and control the gripping forces they apply to tissues. The group also has expertise in developing novel bio-adhesive materials that use microscopic patterns to grip tissue while avoiding damage.*Research Plan:There is a clear need for better surgical grasping instruments and a definite opportunity to use engineering methods to improve the situation. The aim is to optimise the surgical grasper's performance so that they grip securely while minimising/eliminating damage to the patients' tissues. This comes in two parts; 1) an experimental study to increase our understanding of grasper performance 2) integrating our bio-adhesive materials in a grasper to improve grip at lower grasping forces.Experimental Study: Through our previous work we will develop a system to reproduce surgical grasping in the lab using samples of model tissue. This will be used to investigate grasper performance in an experimental study, providing detailed data on how the system responds as both grasp and pulling forces are varied. This information will be linked with clinical measures of tissue damage (showing how tissue cells are effected) to determine which grasping conditions which are unsafe for use.Optimised Grasper: Using knowledge from the study, an improved grasper system will be developed by selecting an appropriate bio-adhesive material that can be integrated onto the grasper's jaws. This will use our expertise in the area to provide a grasper that offers enhanced grip at lower grasping forces to prevent tissue damage.*Outcomes:This research offers to provide exciting advances in healthcare through the application of engineering science to a surgical application. The outcomes from the research will have benefits locally (developing the research and group led by the early-career applicants) and nationally (in science, engineering and clinical research). They will inform surgical training and are highly valuable to the medical device industry. To ensure these benefits reach their broad audience the work will be 1) published in multidisciplinary journals 2) discussed at academic and industry conferences/seminars 3) prepared for future commercialisation using expert resources at the host university.

* 概述：本研究将改进锁孔手术中使用的手术器械，使其对患者造成的伤害更小，同时帮助外科医生更有效地操作。这些有价值的目标将通过该项目的首席工程师和外科医生之间的密切合作来实现，将精确的实验方法，新颖的材料和设计以及临床专业知识结合在一起。这项令人兴奋的研究成果将有助于科学家，工程师和临床医生的研究，并具有改善社会和经济的巨大潜力。背景：现代手术越来越多地使用微创手术（MIS）技术（或“锁孔手术”）。在MIS中，外科医生使用摄像机和通过小的进入“端口”插入体内的长器械对组织进行操作。MIS的优点是实质性的，包括患者恢复更快和并发症更少。然而，长器械使得外科医生难以“感觉”体内的组织。这对于外科手术抓钳是一个特别的问题，外科手术抓钳是一种类似钳子的器械，用于代替外科医生的手来保持和移动组织。对于外科医生来说，适当使用抓钳至关重要，但很难实现;抓或拉得太用力会导致组织损伤并对患者造成潜在的致命后果，但抓得太轻会有组织滑落的风险申请人领导外科技术研究小组，并在使用工程技术来测量和理解外科手术的行为方面具有很强的背景。器械及其与组织的相互作用。他们监督研究开发抓钳系统，可以记录和控制它们施加在组织上的夹持力。该小组还拥有开发新型生物粘合剂材料的专业知识，这些材料使用微观模式来夹紧组织，同时避免损伤。研究计划：显然需要更好的手术抓取工具，并有明确的机会使用工程方法来改善这种情况。其目的是优化手术抓钳的性能，使其能够牢固夹持，同时最大限度地减少/消除对患者组织的损伤。这分为两部分; 1）一项实验研究，以增加我们对抓钳性能的理解2）将我们的生物粘附材料集成到抓钳中，以提高在较低抓力下的抓地力。实验研究：通过我们以前的工作，我们将开发一个系统，使用模型组织样本在实验室中重现手术抓地力。这将被用来调查抓钳性能的实验研究，提供详细的数据，系统如何响应，因为这两个抓地力和拉力是不同的。这些信息将与组织损伤的临床测量（显示组织细胞如何受到影响）相联系，以确定哪些抓取条件不安全。优化的抓钳：利用研究中获得的知识，通过选择可以集成到抓钳钳口上的适当生物粘合剂材料，将开发出一种改进的抓钳系统。这将利用我们在该领域的专业知识，提供一种抓钳，以较低的抓力提供增强的抓力，以防止组织损伤。*结果：这项研究通过将工程科学应用于外科应用，提供了令人兴奋的医疗保健进展。研究成果将在当地（发展由早期职业申请人领导的研究和小组）和全国（科学，工程和临床研究）受益。它们将为手术培训提供信息，对医疗器械行业非常有价值。为了确保这些好处能够惠及广大受众，这些工作将1）在多学科期刊上发表2）在学术和行业会议/研讨会上讨论3）利用主办大学的专家资源为未来的商业化做好准备。

项目成果

Laparoscopic Motor Learning and Workspace Exploration.

腹腔镜运动学习和工作空间探索。

• DOI: 10.1016/j.jsurg.2016.05.001
• 发表时间: 2016
• 期刊: Journal of surgical education
• 影响因子: 2.9
• 作者: White AD