Engineering Improvements in Surgery: Optimisation of Surgical Graspers

*概述：这项研究将改进锁孔手术中使用的手术器械，使它们对患者造成的损害更小，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关系来实现，将精确的实验方法、新材料以及设计和临床专业知识结合在一起。这项令人振奋的研究成果将有助于科学家、工程师和临床医生的研究，并具有极大的潜力为社会和经济带来改善。*背景：现代外科越来越多地使用微创外科技术(或‘锁眼手术’)。在管理信息系统中，外科医生使用照相机和长长的器械，通过小通道“端口”插入体内，对组织进行手术。管理信息系统的优点是显著的，包括较快的恢复和较低的并发症。然而，由于器械较长，外科医生很难“感觉”到体内的组织。这是外科手术抓手的一个特别问题，手术抓手是一种类似钳子的工具，用来代替外科医生的手来握住和移动组织。对于外科医生来说，正确使用抓爪是至关重要的，但也很难实现；抓得或拉得太用力会导致组织损伤，对患者可能造成致命后果，但抓得太轻则有组织滑动的风险--使手术变得复杂并延长手术时间。申请者是外科技术研究小组的负责人，在使用工程技术测量和理解手术器械的行为及其与组织的相互作用方面具有很强的背景。他们已经进行了监督研究，以开发具有可以记录和控制它们应用于组织的抓取力的抓取系统。该集团还拥有开发新型生物粘合材料的专业知识，这种材料使用显微图案来抓住组织，同时避免损伤。*研究计划：显然需要更好的外科抓取工具，并有明确的机会使用工程方法来改善这种情况。其目的是优化手术夹持器的性能，使其在牢牢握持的同时将对患者组织的损害降至最低/消除。这包括两个部分：1)实验研究，以增加我们对抓取器性能的了解；2)将我们的生物粘连材料集成到抓取器中，以提高在较低抓持力下的抓取力。实验研究：通过我们之前的工作，我们将开发一种系统，在实验室中使用模型组织样本重现手术抓取。这将被用来在实验研究中调查抓取器的性能，提供系统在抓取力和拉力不同时如何响应的详细数据。这些信息将与组织损伤的临床测量(显示组织细胞是如何受到影响的)联系起来，以确定哪些抓取条件不安全使用。优化的抓取器：利用研究中的知识，将通过选择可以集成到抓取器的下巴上的适当的生物黏附材料来开发改进的抓取器系统。这将利用我们在该领域的专业知识提供一种抓持器，在较低的抓持力下提供更强的抓持力，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，在保健方面取得了令人兴奋的进展。这项研究的结果将在当地(发展由职业早期申请者领导的研究和小组)和全国(在科学、工程和临床研究方面)受益。它们将为外科培训提供信息，对医疗器械行业具有很高的价值。为了确保这些好处惠及广大受众，将1)在多学科期刊上发表文章，2)在学术和行业会议/研讨会上进行讨论，3)利用主办大学的专家资源为未来的商业化做准备。

*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.