Blood vessel detection, localization and estimation using a smart laparoscopic grasper: a Monte Carlo study

Area of Science:

• Surgical Technology
• Biomedical Engineering
• Medical Imaging

Background:

• Minimally invasive surgery (MIS) offers patient benefits but faces challenges in complex procedures due to limited visibility of vital structures like blood vessels.
• Complicating factors such as inflammation, obesity, and scar tissue exacerbate these challenges, often leading to conversion to open surgery and increased operating times.
• Current imaging techniques struggle to detect embedded blood vessels, hindering the wider adoption of MIS in specialties like colorectal and thoracic surgery.

Purpose of the Study:

• To develop and validate a novel imaging technology for laparoscopic graspers to enhance visualization of embedded blood vessels.
• To improve the safety and efficiency of minimally invasive surgery by providing surgeons with real-time identification of critical vascular structures.
• To drive greater adoption of minimally invasive approaches in complex surgical procedures by overcoming current visualization limitations.

Main Methods:

• Integration of near-infrared (NIR) LEDs and a linear image sensor onto the opposing jaws of laparoscopic graspers.
• Utilizing Monte Carlo simulations to model the detection capabilities of the NIR system for embedded blood vessels.
• Developing and testing a handheld prototype grasper in ex vivo experiments to validate simulation results.

Main Results:

• Monte Carlo simulations predicted the detection of blood vessels (2-6 mm diameter) buried up to 1 cm beneath tissue.
• Ex vivo experiments with the smart grasper prototype demonstrated accurate localization and size estimation of blood vessels.
• Experimental results showed a strong correlation between estimated and actual blood vessel sizes, validating the simulation predictions.

Conclusions:

• The developed NIR-based laparoscopic grasper technology effectively detects embedded blood vessels, even those not visible with current methods.
• This technology has the potential to significantly reduce conversion rates from MIS to open surgery and decrease operative times in complex procedures.
• Incorporation into existing laparoscopic tools can enhance surgeon capabilities, promoting broader application of minimally invasive techniques in challenging surgical fields.