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2008 Annual Meeting Abstracts
Measurement of Force Feedback in Laparoscopy: A Step Toward Safer Surgery?
Brant R Fulmer1, Donna Ebenstein*2, Alexis Paskert*2, Sandra Deitch*1, Joseph Tranquillo*2
1Geisinger Medical Center, Danville, PA;2Bucknell University, Lewisburg, PA
Introduction: Trocars are used universally in laparoscopy to insert instrumentation through the body wall. Direct and fulcrum forces are applied to the trocar and thus to the tissues. Despite widespread use of trocars, little is known about how these forces are transferred to patients. Robotic systems with minimal haptic feedback further disconnect the surgeon from the patient. The goal of this project was to design a system for force feedback and study force translation through laparoscopic trocars.
Methods: This project was a unique collaboration between a student design team, biomedical engineer, and urology mentor. Problem identification, solution design, and prototype production were performed. Proof of concept was achieved as well as development of a working prototype.
Results: Using a plastic trocar, strain gauges were fixed in four quadrants around the base. Strain gauges measure the force deformation of the trocar and can be calibrated to known forces. Measured force was then compared to critical force for tissue damage. Feedback utilizing a LED indicator was given when measured force exceeded critical force. The critical force can be changed according to clinical circumstances. Force history recordings for each individual trocar could provide interesting data for further study.
Conclusions: The development of “smart” instrumentation that maintains treatment efficacy and improves patient safety is a desirable evolution in surgery. As a first step, we present a novel system to measure force from laparoscopic trocars that provides surgeon feedback. Further study is needed to determine how this information can be utilized to improve patient outcomes.
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