An autoclavable wireless palpation instrument for minimally invasive surgery.

Abstract

Minimally invasive surgery prevents surgeons from manually palpating organs to locate subsurface tumors and other structures. One solution is to use ultrasound; however, it is not always reliable. Various minimally invasive surgery instruments that provide tactile feedback have been proposed to augment ultrasound sensing for tumor localization; however, current designs have limitations such as cumbersome wiring, difficulty in manipulation, lack of sterilizability and high cost. This paper presents a novel, autoclavable, wireless, hand-held palpation instrument that uses a custom, low-cost, disposable tactile sensor to provide tactile and kinesthetic force feedback. The use of a replaceable, disposable tactile sensor avoids deterioration in sensor performance due to repeated autoclaving. The instrument features a passive joint in the end effector that allows the sensor to self-align to the palpation surface in a wide range of orientations. All of the electronics are packaged in a removable module that allows the rest of the instrument to be easily cleaned and autoclaved. Two versions of the tactile sensor, using piezoresistive sensing and capacitive sensing respectively, have been designed for use with this instrument. The instrument is shown to be able to detect 6 mm diameter spherical tumors at a depth of 9-10 mm in ex vivo tissue samples.