基于非侵入式电阻抗测量的腹腔镜手术组织辨识系统研究

Laparoscopic surgery (LS) is a surgical technique that offers distinct advantages in reducing patients'pain, trauma and recovery time. However, the drawback of LS due to the lack of tactile feedback results in a great deal of limitations in LS procedures. Some specially designed force sensors have been used to simulate tissue palpation, measuring tissue interaction forces at the tip of a surgical instrument. But only the stiffness is not sufficient to discriminate tissue types because of individual difference and clinicopathologic variance. Therefore, there is still a need for an efficient and simple method which can help the surgeon to identify invivo tissues accurately. Electrical impedance measurement technique represents a good way to investigate electrical properties of biological tissues. The previous experimental results have indicated that the noninvasive electrical impedance sensor, integrated with force sensing function, can provide accurate and reliable biological tissue discrimination. In this study, some technical performances of the sensor, such as value of force , distance between probes and measurement depth. We determine to build the experimental environment and discriminate biological tissue in LS. The noninvasive electrical impedance sensor can overcome the drawback of LS due to the lack of tactile tense feedback, and it has wide theoretical and application prospects.

腹腔镜手术具有开放手术无可比拟的优势。但到目前为止，仅仅能实施少数相对较复杂的手术，其中术者手触觉反馈功能丧失是其主要问题之一，有学者应用特殊力传感器或力的测量代替术者触觉的方法因为仅仅从质地特性来进行组织判断而不能应用于临床。因此，需要寻找更加有效的方法帮助医生在手术中进行组织识别。文献报道，生物电阻抗参数是区别组织类别和病理状态的重要指标。我们的前期实验显示，通过具有力传导功能的电阻抗测量的非侵入性方法可以区别腹腔内器官并可以在器官表面自由移动。我们设想，通过动物实验，掌握具有力传导功能的非侵入式生物阻抗测量技术各项指标，如力的大小、电极间距、测量深度等，并构建相应的操作系统，进行腹腔镜手术下器官识别。如此设想得以实现，将能够克服腔镜手术下手触觉功能缺失的弊端，具有重大的理论和应用前景。

腹腔镜手术具有开放手术无可比拟的优势。但到目前为止，仅仅能实施少数相对较复杂的手术，其中术者手触觉反馈功能丧失是其主要问题之一，有学者应用特殊力传感器或力的测量代替术者触觉的方法因为仅仅从质地特性来进行组织判断而不能应用于临床。因此，需要寻找更加有效的方法帮助医生在手术中进行组织识别。我们的实验结果已经证明通过具有力传导功能的电抗测量的非侵入性方法可以区别腹腔内器官并可以在器官表面自由移动。掌握了具有力传导功能的非侵入式生物阻抗测量技术各项指标，如力的大小、电极间距、测量深度等。设计了一种恒力输出系统，该系统不受术者手的影响，在与组织接触时能够保持测量力的相对恒定，获得了稳定的阻抗值输出并能保证电极与组织接触时不受损伤。为保持肾部分切除术恒定的切缘厚度，研究并提出肾部分切除术手术切缘厚度与电阻抗之间呈固定的线性关系。