CPS: Autonomous Attainment of Tissue-Centricity in Electrosurgery through Data-Driven Persistently Evolving Thermogeometric Adaptivity

CPS：通过数据驱动的持续发展的热几何适应性在电外科中自主实现以组织为中心

• 批准号: 9985404
• 负责人: Joseph Bentsman
• 金额: $ 36.26万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9985404
• 关键词: Algorithms; Anesthetics; Awareness; Biological Sciences; Burn injury; Caring; Coagulation Process; Computer software; Data; Electrodes; Electrosurgery; Engineering; Excision; Hemostatic function; Individual; Injury; Instruction; Malignant - descriptor; Medical; Mission; Necrosis; Operative Surgical Procedures; Patients; Regulation; Research Design; Research Methodology; Robotics; Salvelinus; Sepsis; Stream; Structure; Surgeon; Techniques; Test Result; Time; Tissue Model; Tissues; Vision; Visual; adverse outcome; base; cost; cyber physical; design; flexibility; improved; mortality; multimodality; novel; sensor; software development; surgery outcome; tool; voltage

1. The Main Project Objective. Electrosurgery has become the leading surgical technique due to its low cost, adaptability, and capability for simultaneous cutting and hemostasis. However, at present surgeon maintains fixed mode and power level, routinely exceeding the required minimum. This gives rise to tissue charring, necrosis, and excessive voltage prone to cause injuries. The broad objective of this project is to mitigate the adverse consequences of a priori fixing mode/power, especially in laparoscopic and robotic setting, through enabling a paradigm shift - from surgeon-centric to tissue-centric. The latter consists in adaptively optimizing the actual operating conditions for maximum tissue benefit, while autonomously transitioning between modes, instead of holding the preset cut, mixed, or coagulation mode and its power. 2. Specific Aims. To enable the novel paradigm, specific aims consist in 1) developing i) multiscale control/display-oriented surgically-relevant tissue models through mutually reinforced first-principles and Al/data-driven formalisms, ii) multimodal software-sensor-based tissue-centric sensing, and iii) multiscale network adaptive tissue-centric control algorithms; 2) integrating them into a coherent cyber-physical design paradigm and constructing, on its basis, a multifunctional electrosurgical tool; 3) enabling a tissue-aware operating surgeon interface via real-time visual tissue status streaming, and 4) extensively testing resulting electrosurgical setting on perfused tissue . 3. Relevance to BIMIT Mission. The project integrates physical, engineering, and life sciences to improve medical care through developing electrosurgical paradigm for maximum tissue/patient benefit. 4. Research Design and Methods. 1) advance precarbonization sensing both fundamentally and technically, 2) design and implement a real-time multi-modal (thermal/vision/spectroscopic) sensor array that characterizes onset of the tissue condition corresponding to each of the modes, 3) in place of a single monopolar probe, design and build a fused array of flexible isolated electrodes to form a reconfigurable multi-arcing spatially-mixed-mode thermogeometric footprint, 4) develop software to aggregate fused probe and multi-modal sensor array into a hierarchical evolving structure to deliver the real-time-optimized thermogeometrically adaptable electrosurgical footprint through closed-loop individual mode selection /power regulation in each microprobe, 5) develop software for tissue-aware surgeon interface.

1.主要项目目标。由于其低成本，电外科手术已成为领先的外科技术 成本、适应性以及同时切割和止血的能力。目前，外科医生 保持固定的模式和功率水平，经常超过所需的最低值。这就产生了组织 炭化、坏死，电压过高易造成损伤。该项目的总体目标是 减轻先验固定模式/功率的不良后果，尤其是在腹腔镜和机器人中 通过实现范式转变-从以外科医生为中心到以组织为中心。后者包括 自适应地优化实际操作条件以获得最大组织益处，同时自主地 在模式之间转换，而不是保持预设的切割、混合或凝固模式及其功率。 2.具体目标。为了使新的范式，具体目标包括：1）开发i）多尺度 - 通过相互加强的第一原理控制/显示导向的解剖学相关的组织模型， AI/数据驱动的形式主义，ii）基于多模态软件传感器的组织中心感测，以及iii）多尺度 网络自适应组织为中心的控制算法; 2）将它们集成到一个连贯的网络物理 设计范例并在其基础上构建多功能电外科工具; 3）使 经由实时可视组织状态流传输的组织感知手术外科医生界面，以及4）广泛地 在灌注组织上测试产生的电外科设置。 3.与BIMIT使命相关。该项目整合了物理、工程和生命科学， 通过开发电外科范例进行医疗护理，以获得最大的组织/患者受益。 4.研究设计和方法。1)先进的预碳化检测， 技术上，2）设计并实现实时多模态（热/视觉/光谱）传感器阵列 其表征对应于每个模式的组织状况的开始，3）代替单个 单极探头，设计和构建柔性隔离电极的融合阵列，以形成可重构的 多弧空间混合模式热几何足迹，4）开发软件来聚集熔断体 探头和多模态传感器阵列到一个层次不断发展的结构，以提供实时优化的 通过闭环单独模式的热几何适应性电外科覆盖区 每个微探针中的选择/功率调节，5）开发用于组织感知外科医生接口的软件。