A three-constituent damage model for arterial clamping in computer-assisted surgery

Area of Science:

• Biomedical Engineering
• Computational Mechanics
• Surgical Innovation

Background:

• Robotic surgery offers precision but lacks tactile feedback, risking tissue damage during manipulation.
• Safe loading limits for arterial clamping in complex deformations are currently unknown.
• Minimizing tissue damage is crucial for improving surgical outcomes and patient safety.

Purpose of the Study:

• To develop and validate a continuum damage model for arterial tissue.
• To predict arterial stiffness degradation and identify critical loading regimes during surgical procedures.
• To assess the potential of computational tools for optimizing surgical interventions and enhancing robotic surgery.

Main Methods:

• A continuum damage model was developed for arterial tissue, incorporating extracellular matrix, collagen fibers, and smooth muscle cells.
• The model was implemented in a finite element setting within commercial software to track damage progression.
• Simulations included arterial clamping with residual strains and subsequent isometric contraction experiments, validated against in vivo data.

Main Results:

• The computational model successfully predicted regional variations in smooth muscle cell damage.
• Simulations demonstrated the capability to identify critical loading regimes leading to arterial stiffness degradation.
• Model predictions showed good agreement with actual in vivo experimental results.

Conclusions:

• The developed finite element model serves as a valuable tool for optimizing surgical instruments to minimize tissue damage.
• This computational approach can inform real-time adjustments in computer-assisted surgery for safer robotic tissue manipulation.
• The model has the potential to establish safe loading parameters, reducing iatrogenic injury during complex surgical procedures.