Effect of the thickness and nonlinear elasticity of tissue on the success of surgical stapling for laparoscopic liver resection.

Recently, the range of applications of surgical staplers has been extended to include laparoscopic liver resection because manipulation of a surgical stapler is very simple. Revealing the causes of stapling failure and suggesting a method to solve stapling failure are important for safe laparoscopic liver resection. Surgeons say that tissues make stapling more likely to fail if they are thick and brittle. However, the combinatorial effect of the thickness and stiffness of tissues on the success of surgical stapling for laparoscopic liver resection has not been investigated. Therefore, the objective of the present study was to investigate the effect of tissue thickness and tissue stiffness on the success rate (SR) of surgical stapling. From ex vivo stapling experimental results using pig livers, it is suggested that the effect of tissue thickness is greater than the effect of tissue stiffness on the SR of stapling. If tissue thickness is 5 mm, the SR of stapling is high regardless of the magnitude of the tissue-stiffness parameter. However, if tissue thickness is >10 mm, the SR of stapling has a relationship with nonlinear viscoelastic parameters. Therefore, the SR of stapling could be predicted from tissue thickness and nonlinear elastic parameters.

Modeling of lung's electrical impedance using fractional calculus for analysis of heat generation during RF-ablation.

Recently, Radio Frequency Ablation (RFA) is becoming a popular therapy for various cancers such as liver, breast, or lung cancer. RFA is one kinds of thermal therapy. However, it has been often reported about excessive ablation or non-ablation due to difficult control of ablation energy. In order to solve these difficulties, we have been proposed robotized RF-ablation system for precise cancer treatment. We have been tried to control heat energy by control of electromagnetic-wave frequency. In this paper, we reported about relation among electrical impedance of lung, lung's internal air volumes, and heat energy by use of electromagnetic-wave. In case of RFA for lung cancer, heat energy depends on electrical impedance and lung's internal air volumes. Electrical impedance has the dependence of electromagnetic-wave frequency and the dependence of lung's internal air volumes. Therefore, firstly we considered about fractional calculus model between lung's internal air volumes and electrical impedance. Secondly, we measured electric impedance frequency characteristic of lung with change of lung's internal air volumes. The measured and modeled results showed that use of fractional calculus realized high accurate model for electrical impedance of lung. And, from the results of numerical analysis of heat energy, it is supposed that control of electromagnetic-wave frequency has a small effectiveness for lung tissue ablation even if lung includes abundant air.

Derivation of the relationship between the rate of temperature rise and viscoelasticity for constructing a coagulation model for liver radio frequency ablation.

Radio frequency ablation (RFA) is usually conducted using ultrasound (US) imaging to monitor the insertion procedure and the coagulation extent of liver tissue which is contiguous to the RFA electrode. However, when RFA surgery is started, the US image becomes unclear because of water vapor. This disadvantage of RFA can lead to excessive and insufficient RFA thereby diminishing the advantages of the procedure. In the present study, we proposed a simulation system which shows the progress status of coagulation for liver RFA. To derive the coagulation characteristics in liver RFA, we used the viscoelasticity of liver tissue as the coagulation indicator to investigate coagulation development for liver RFA. This paper shows the acquisition procedures for analyzing the relationship between the rate of temperature and viscoelasticity. We measured the complex modulus of porcine liver tissue under different rate of temperature in RFA by controlling the output power. We showed that the viscoelasticity of liver tissue depended on temperature previous temperature increase above 60°C. This result indicates that in RFA, controlling the output power is important to completely coagulate the tumor.

The relation between temperature distribution for lung RFA and electromagnetic wave frequency dependence of electrical conductivity with changing a lung's internal air volumes.

Radio frequency ablation (RFA) for lung cancer has increasingly been used over the past few years because it is a minimally invasive treatment. As a feature of RFA for lung cancer, lung contains air during operation. Air is low thermal and electrical conductivity. Therefore, RFA for this cancer has the advantage that only the cancer is coagulated, and it is difficult for operators to control the precise formation of coagulation lesion. In order to overcome this limitation, we previously proposed a model-based robotic ablation system using finite element method. Creating an accurate thermo physical model and constructing thermal control method were a challenging problem because the thermal properties of the organ are complex. In this study, we measured electromagnetic wave frequency dependence of lung's electrical conductivity that was based on lung's internal air volumes dependence with in vitro experiment. In addition, we validated the electromagnetic wave frequency dependence of lung's electrical conductivity using temperature distribution simulator. From the results of this study, it is confirmed that the electromagnetic wave frequency dependence of lung's electrical conductivity effects on heat generation of RFA.

Real-time temperature control system based on the finite element method for liver radiofrequency ablation: effect of the time interval on control.

Radiofrequency (RF) ablation is increasingly being used to treat liver cancer because it is minimally invasive. However, it is difficult for operators to control the size of the coagulation zones precisely, because no method has been established to form an adequate and suitable ablation area. To overcome this limitation, we propose a new system that can control the coagulation zone size. The system operates as follows: 1) the liver temperature is estimated using a temperature-distribution simulator to reduce invasiveness; 2) the output power of the RF generator is controlled automatically according to the liver temperature. To use this system in real time, both the time taken to calculate the temperature in the simulation and the control accuracy are important. We therefore investigated the relationship between the time interval required to change the output voltage and temperature control stability in RF ablation. The results revealed that the proposed method can control the temperature at a point away from the electrode needle to obtain the desired ablation size. It was also shown to be necessary to reduce the time interval when small tumors are cauterized to avoid excessive treatment. In contrast, such high frequency feedback control is not required when large tumors are cauterized.

A method for deriving the coagulation boundary of liver tissue using a relational model of viscoelasticity and temperature in radio frequency ablation.

Recently radiofrequency (RF) ablation has become increasingly important in treating liver cancers. RF ablation is ordinarily conducted using elastographic imaging to monitor the ablation procedure and the temperature of the electrode needle is displayed on the RF generator. However, the coagulation boundary of liver tissue in RF ablation is unclear and unconfident. This can lead to both excessive and insufficient RF ablation thereby diminishing the advantages of the procedure. In the present study, we developed a method for determining the coagulation boundary of liver tissue in RF ablation. To investigate this boundary we used the mechanical characteristics of biochemical components as an indicator of coagulation to produce a relational model for viscoelasticity and temperature. This paper presents the data acquisition procedures for the viscoelasticity characteristics and the analytical method used for the coagulation model. We employed a rheometer to measure the viscoelastic characteristics of liver tissue. To determine the model functional relationship between viscoelasticity and temperature, we used a least-square method and the minimum root mean square error was calculated to optimize the model functional relations. The functional relation between temperature and viscoelasticity was linear and non-linear in different temperature regions. The boundary between linear and non-linear functional relation was 58.0°C.

A study on estimation of the deformation behavior in the collapse process of lung.

In this paper, finite element methodology was applied to predict the deformation of tissue during lung collapse using pre-operative information. Accurate prediction of lung collapse deformation prior to surgical intervention can provide valuable diagnostic information to clinical staff, allowing a better understanding of the movement of the target segment. This paper describe the methodology to derive the deformed shape of finite element model that satisfy the equilibrium condition using 3-D model developed from the image measured by a multi-slice CT imaging device. The movement of the target segment can be predicted by the finite element model. Previous research studies applied the distributed load on the surface of the lung structure as loading conditions. Here we have suggested a method that considers the deformation of alveoli contraction and elongation while breathing. Specifically, by introducing the governing equations of a reduction in volume strain into the governing equations of the finite element method, lung structure is analyzed. Lung deformation obtained from the analysis was compared with experimental results and compared with the proposed method. The proposed method showed an improvement of deformation-prediction accuracy as 0.58%. We confirmed the qualitative similarities between the deformation of the analysis and the experiment, thus demonstrating the effectiveness of the proposed method.

Development of a temperature distribution simulator for lung RFA based on air dependence of thermal and electrical properties.

Radio frequency ablation (RFA) for lung cancer has increasingly been used over the past few years, because it is a minimally invasive treatment. As a feature of RFA for lung cancer, lung contains air. Air is low thermal and electrical conductivity. Therefore, RFA for this cancer has the advantage that only the cancer is coagulated, because the heated area is confined to the immediate vicinity of the heating point. However, it is difficult for operators to control the precise formation of coagulation zones due to inadequate imaging modalities. We propose a method using finite element method to analyze the temperature distribution of the organ in order to overcome the current deficiencies. Creating an accurate thermal physical model was a challenging problem because of the complexities of the thermal properties of the organ. In this study, we developed a temperature distribution simulator for lung RFA using thermal and electrical properties that were based on the lung's internal air dependence. In addition, we validated the constructed simulator in an in vitro study, and the lung's internal heat transfer during RFA was validated quantitatively.

Validation of accuracy of liver model with temperature-dependent thermal conductivity by comparing the simulation and in vitro RF ablation experiment.

Radiofrequency (RF) ablation is increasingly used to treat cancer because it is minimally invasive. However, it is difficult for operators to control precisely the formation of coagulation zones because of the inadequacies of imaging modalities. To overcome this limitation, we previously proposed a model-based robotic ablation system that can create the required size and shape of coagulation zone based on the dimensions of the tumor. At the heart of such a robotic system is a precise temperature distribution simulator for RF ablation. In this article, we evaluated the simulation accuracy of two numerical simulation liver models, one using a constant thermal conductivity value and the other using temperature-dependent thermal conductivity values, compared with temperatures obtained using in vitro experiments. The liver model that reflected the temperature dependence of thermal conductivity did not result in a large increase of simulation accuracy compared with the temperature-independent model in the temperature range achieved during clinical RF ablation.

Estimation of intraoperative blood flow during liver RF ablation using a finite element method-based biomechanical simulation.

Radiofrequency ablation is increasingly being used for liver cancer because it is a minimally invasive treatment method. However, it is difficult for the operators to precisely control the formation of coagulation zones because of the cooling effect of capillary vessels. To overcome this limitation, we have proposed a model-based robotic ablation system using a real-time numerical simulation to analyze temperature distributions in the target organ. This robot can determine the adequate amount of electric power supplied to the organ based on real-time temperature information reflecting the cooling effect provided by the simulator. The objective of this study was to develop a method to estimate the intraoperative rate of blood flow in the target organ to determine temperature distribution. In this paper, we propose a simulation-based method to estimate the rate of blood flow. We also performed an in vitro study to validate the proposed method by estimating the rate of blood flow in a hog liver. The experimental results revealed that the proposed method can be used to estimate the rate of blood flow in an organ.

Modeling the internal pressure dependence of thermal conductivity and in vitro temperature measurement for lung RFA.

Radio frequency ablation (RFA) for lung cancer has increasingly been used over the past few years because RFA is minimally invasive treatment for patients. As a feature of RFA for the lung cancer, lung has the air having low thermal conductivity. Therefore, RFA for lung has the advantage that only the tumor is coagulated because heating area is confined to the immediate vicinity of the heating point. However, it is difficult for operators to control the precise formation of coagulation zones due to inadequate imaging modalities. We propose a method using numerical simulation to analyze the temperature distribution of the organ in order to overcome the current deficiencies. Creating an accurate thermophysical model was a challenging problem because of the complexities of the thermophysical properties of the organ. In this work, as the processes in the development of ablation simulator, measurement of the pressure dependence of lung thermal conductivity and in vitro estimation of the temperature distribution during RFA is presented.

Temperature dependence of thermal conductivity of liver based on various experiments and a numerical simulation for RF ablation.

Radiofrequency ablation (RFA) for liver cancer has increasingly been used over the past few years because RFA is minimally invasive treatment for patients. However, precise control of the formation of coagulation zones is difficult for operators due to inadequate imaging modalities. With this in mind, we have proposed a model-based robotic ablation system using numerical simulation to analyze temperature distributions in the organ to overcome this deficiency. The objective of our work is to develop a temperature-dependent thermophysical organ model to construct a precise numerical simulator for RFA. However, no standard methods exist for obtaining the thermophysical properties of biological tissues, as detailed evaluations of the accuracy of properties obtained from various experiments have not been completed. The purpose of this study was thus to measure and model the temperature dependence of thermal conductivity in hog liver from three representative methods, and to compare these results using our developed numerical simulator to reveal differences in temperature distributions stemming from differences in thermal conductivities.