Grasper integrated tri-axial force sensor system for robotic minimally invasive surgery.

This paper describes the design, microfabrication, and characterization of a miniature force sensor for providing tactile feedback in robotic surgical systems. We demonstrate for the first time a microfabricated sensor that can provide triaxial sensing (normal, x-shear, y-shear) in a single sensor element that can be integrated with commercial robotic surgical graspers. Features of this capacitive force sensor include differential sensing in the shear directions as well as a design where all electrical connections are on one side, leaving the backside pristine as the sensing face. The sensor readout is performed by a custom-designed printed circuit board with 24-bit resolution. Experimental results of sensor performance show normal force resolution of 0.055 N, x-shear resolution of 0.25 N, and y-shear resolution of 1.45 N, all of which fall in a range of clinically relevant forces.

Tensile strength and failure load of sutures for robotic surgery.

BACKGROUND: Robotic surgical platforms have seen increased use among minimally invasive gastrointestinal surgeons (von Fraunhofer et al. in J Biomed Mater Res 19(5):595-600, 1985. doi: 10.1002/jbm.820190511 ). However, these systems still suffer from lack of haptic feedback, which results in exertion of excessive force, often leading to suture failures (Barbash et al. in Ann Surg 259(1):1-6, 2014. doi: 10.1097/SLA.0b013e3182a5c8b8 ). This work catalogs tensile strength and failure load among commonly used sutures in an effort to prevent robotic surgical consoles from exceeding identified thresholds. Trials were thus conducted on common sutures varying in material type, gauge size, rate of pulling force, and method of applied force. METHODS: Polydioxanone, Silk, Vicryl, and Prolene, gauges 5-0 to 1-0, were pulled till failure using a commercial mechanical testing system. 2-0 and 3-0 sutures were further tested for the effect of pull rate on failure load at rates of 50, 200, and 400 mm/min. 3-0 sutures were also pulled till failure using a da Vinci robotic surgical system in unlooped, looped, and at the needle body arrangements. RESULTS: Generally, Vicryl and PDS sutures had the highest mechanical strength (47-179 kN/cm2), while Silk had the lowest (40-106 kN/cm2). Larger diameter sutures withstand higher total force, but finer gauges consistently show higher force per unit area. The difference between material types becomes increasingly significant as the diameters decrease. Comparisons of identical suture materials and gauges show 27-50% improvement in the tensile strength over data obtained in 1985 (Ballantyne in Surg Endosc Other Interv Tech 16(10):1389-1402, 2002. doi: 10.1007/s00464-001-8283-7 ). No significant differences were observed when sutures were pulled at different rates. Reduction in suture strength appeared to be strongly affected by the technique used to manipulate the suture. CONCLUSIONS: Availability of suture tensile strength and failure load data will help define software safety protocols for alerting a surgeon prior to suture failure during robotic surgery. Awareness of suture strength weakening with direct instrument manipulation may lead to the development of better techniques to further reduce intraoperative suture breakage.

Fabrication of a thin-film capacitive force sensor array for tactile feedback in robotic surgery.

Although surgical robotic systems provide several advantages over conventional minimally invasive techniques, they are limited by a lack of tactile feedback. Recent research efforts have successfully integrated tactile feedback components onto surgical robotic systems, and have shown significant improvement to surgical control during in vitro experiments. The primary barrier to the adoption of tactile feedback in clinical use is the unavailability of suitable force sensing technologies. This paper describes the design and fabrication of a thin-film capacitive force sensor array that is intended for integration with tactile feedback systems. This capacitive force sensing technology could provide precise, high-sensitivity, real-time responses to both static and dynamic loads. Capacitive force sensors were designed to operate with optimal sensitivity and dynamic range in the range of forces typical in minimally invasive surgery (0-40 N). Initial results validate the fabrication of these capacitive force-sensing arrays. We report 16.3 pF and 146 pF for 1-mm(2) and 9-mm(2) capacitive areas, respectively, whose values are within 3% of theoretical predictions.

Electrochemical properties and myocyte interaction of carbon nanotube microelectrodes.

Arrays of carbon nanotube (CNT) microelectrodes (nominal geometric surface areas 20-200 µm(2)) were fabricated by photolithography with chemical vapor deposition of randomly oriented CNTs. Raman spectroscopy showed strong peak intensities in both G and D bands (G/D = 0.86), indicative of significant disorder in the graphitic layers of the randomly oriented CNTs. The impedance spectra of gold and CNT microelectrodes were compared using equivalent circuit models. Compared to planar gold surfaces, pristine nanotubes lowered the overall electrode impedance at 1 kHz by 75%, while nanotubes treated in O(2) plasma reduced the impedance by 95%. Cyclic voltammetry in potassium ferricyanide showed potential peak separations of 133 and 198 mV for gold and carbon nanotube electrodes, respectively. The interaction of cultured cardiac myocytes with randomly oriented and vertically aligned CNTs was investigated by the sectioning of myocytes using focused-ion-beam milling. Vertically aligned nanotubes deposited by plasma-enhanced chemical vapor deposition (PECVD) were observed to penetrate the membrane of neonatal-rat ventricular myocytes, while randomly oriented CNTs remained external to the cells. These results demonstrated that CNT electrodes can be leveraged to reduce impedance and enhance biological interfaces for microelectrodes of subcellular size.