New device with force sensors for laparoscopic liver resection – investigation of grip force and histological damage

Abstract

Introduction

As the benefits of minimally invasive surgery are recognized, the rate of laparoscopic liver resection (LLR) is rapidly increasing. Liver tissue is fragile compared to tissue of the stomach and colon. In endoscopic and robotic surgery, sufficient tactile sensation is yet to be obtained. Therefore, it is necessary to measure and indicate the grip force of forceps during surgery. We developed a new device consisting of force sensors and investigated its grip force and the resulting histological damage to liver tissue.

Material and methods

We measured the grip force generated during laparoscopic surgery in pigs using the forceps with pressure sensors developed by us. Throughout the hepatectomy, we measured the grip force generated by the forceps in real time. We investigated the histological damage to the liver caused by using the forceps with different grip forces.

Results

The subject produced a mean grip force of 1.75 N during the procedures. The maximum grip force was 3.38 N. By grasping the tissues of the liver with forceps, bleeding and destruction of the hepatic lobules were observed in a manner dependent on increasing grip force.

Conclusion

The new device is necessary for preventing liver damage in laparoscopic hepatic resection.

Keywords:

• Laparoscopy
• hepatectomy
• grip force
• force measurement system

Declaration of interest

All authors indicate that they have no financial interests or potential conflicts of interest to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Japan Agency for Medical Research and Development under grant number JP18he1702004.