Purpose

Noninvasiveness and stability are significant issues in laparoscopic liver resection. Inappropriate grasping force can cause damage or serious bleeding to the liver. In addition, instability of grasping can result unsafe operations or wavered cutting. We propose a surgical device to improve stability of liver manipulation.

Methods

A proposed device adheres to the liver surface with suction fixation, then tunes its stiffness to being hard and shapes like as a bulge on the liver surface to be grasped with laparoscopic forceps. It consists of two soft beams, a chamber sponge, membrane covering the device upper, suburb extrusion wing membrane, a vacuuming tube and to-be-grasped bars. The beams are designed as being non-stretchable and easy to bend. The device is connected to a medical vacuuming pump to vacuum air in the device and then gets hard to transfer forceps operation well. This stiffness tuning mechanism by pneumatic control features the device for achieving good liver shape followability and forceps operation propagation less invasively. The proposed device was tested with rubber phantoms and porcine livers on shape followability, stiffness transition, liver invasiveness and operational usability in the experiments.

Results

Performance of the proposed device was assessed in experiments. The device showed good object-shape followability. It held the liver with 2.43-N force for vertical lifting and 4.90-N shear force with − 80 kPa vacuuming pressure. Invasiveness was reduced to acceptable level of liver damage. In usability test, the device grasped the liver stably and transferred surgical forceps operations to the liver surface well.

Conclusion

The proposed device showed effective performance to improve laparoscopic liver manipulation. It held the liver stably and less invasively and transferred forceps operation force to the liver surface well.

中文翻译：

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吸腹手术器械，可协助腹腔镜钳操作肝脏。

目的

无创性和稳定性是腹腔镜肝切除术中的重要问题。抓握力不当会导致肝脏损坏或严重出血。另外，抓握的不稳定性会导致操作不安全或切割不稳。我们提出一种外科手术装置，以改善肝脏操作的稳定性。

方法

所提出的装置通过抽吸固定粘附在肝表面上，然后将其刚度调整为坚硬，并且形状像要在腹腔镜钳上抓住的肝表面上的凸起。它由两个软梁，一个腔室海绵，覆盖设备上部的薄膜，郊区挤压机翼薄膜，一个吸尘管和待抓握的杆组成。横梁设计为不可拉伸且易于弯曲。该设备连接到医用真空泵上，以真空吸除设备中的空气，然后很难将镊子良好地转移。这种通过气动控制的刚度调节机制的特征在于，该装置可实现良好的肝脏形状跟随性，并且钳子的手术侵入性较小。拟议的设备已通过橡胶体模和猪肝进行了形状跟随性，刚度转变，

结果

在实验中评估了所提出设备的性能。该装置显示出良好的物体形状跟随性。它以2.43N的力垂直向上举起肝脏，并以-80 kPa的真空压力保持4.90N的剪切力。侵袭性降低至肝脏损害的可接受水平。在可用性测试中，该设备稳定地抓住了肝脏，并将手术钳操作良好地转移到了肝脏表面。

结论

提出的装置显示出改善腹腔镜肝脏操作的有效性能。它稳定地握住了肝脏，并且侵入性更小，并且将钳子的操作力很好地传递到了肝脏表面。