Design and Evaluation of a Novel Hybrid Soft Surgical Gripper for Safe Digital Nerve Manipulation.

Jin Guo,Chen-Hua Yeow,Yoke-Rung Wong,Jin-Huat Low

doi:10.3390/mi10030190

Jin Guo, Chen-Hua Yeow + Show 2 more

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https://doi.org/10.3390/mi10030190

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Abstract

Forceps are essential tools for digital nerve manipulation during digital nerve repair surgery. However, surgeons have to operate forceps with extreme caution to prevent detrimental post-operative complications caused by over-gripping force. Their intrinsically safe characteristics have led to the increasing adoption of soft robotics in various biomedical applications. In this paper, a miniaturized hybrid soft surgical gripper is proposed for safe nerve manipulation in digital nerve repair surgery. This new surgical gripper includes a soft inflatable actuator and a gripper shell with a hook-shaped structure. The ability to achieve a compliant grip and safe interaction with digital nerves is provided by the inflated soft pneumatic actuator, while the rigid hook retractor still allows surgeons to scoop up the nerve from its surrounding tissues during surgery. The performance of the proposed surgical gripper was evaluated by the contact/pulling force sensing experiments and deformation measurement experiments. In the cadaver experiments, this new surgical gripper was able to complete the required nerve manipulation within the limited working space. The average deformation of the digital nerve with an average diameter of 1.45 mm gripped by the proposed surgical gripper is less than 0.22 mm. The average deformity is less than 15% of its original diameter.

Highlights

Digital nerves are the nerves that supply sensations such as pain, discriminatory touch, or other sensations between the brain and fingers [1]
The size of the new surgical gripper must be determined to guarantee that the new gripper can complete the required nerve manipulation within the limited working space; (2) Deformation: there is lack of in-vivo research to describe the maximum tolerance of digital nerve deformation, it is believed that the neurons can be compressed too far and become dysfunctional
InInorder to to evaluate the performance of theofproposed soft hybrid order evaluate the performance the proposed soft robotic hybrid surgical robotic gripper surgicaldescribed gripper above, threeabove, types three of experiments were conducted: described types of experiments were conducted: (1) Force sensing experiments: to determine the relationship between the pulling/gripping forces

Summary

Introduction

Digital nerves are the nerves that supply sensations such as pain, discriminatory touch, or other sensations between the brain and fingers [1]. They are located with the digital arteries along the sides of each finger. Iatrogenic nerve injuries caused by medical interventions or inflicted accidentally by a treating surgeon may result in digital nerve damage [3,4]. Digital nerve repair is a microsurgical procedure used to treat a severed or damaged nerve by reconnecting the ends of the severed nerve in the hand to allow the nerve to heal, so as to reduce the possibility of scarring, neuroma, or painful growths [5,6]. The damaged ends of the nerve are trimmed to reveal healthy nerve fascicles, which are repaired via end-to-end neurorrhaphy with fine sutures placed in the epineurium (shown in Figure 1a) if the ends of the nerve can be pulled together without

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