Development of an Electrical Impedance Tomography Coupled Surgical Stapler for Tissue Characterization

Area of Science:

• Biomedical Engineering
• Surgical Technology
• Medical Imaging

Background:

• Accurate intraoperative tumor margin assessment is crucial for effective cancer treatment.
• Standard surgical staplers lack the capability for real-time tissue differentiation.
• Electrical Impedance Tomography (EIT) offers a non-invasive method for imaging tissue conductivity variations.

Purpose of the Study:

• To investigate the feasibility of integrating EIT with laparoscopic surgical staplers (stapler+EIT).
• To develop and evaluate an electrode-integrated surgical stapler for intraoperative tissue differentiation.
• To enable precise tumor margin detection during surgery.

Main Methods:

• Designed custom printed-circuit-board electrode arrays (60 and 8 electrodes) integrated into a surrogate stapler.
• Evaluated the stapler+EIT device using simulations and bench-top experiments with agar-gel phantoms and bovine tissue.
• Compared electrode configurations, focusing on a single-jaw (60-electrode) versus dual-jaw distribution.

Main Results:

• A single-jaw electrode array (60 electrodes) significantly outperformed dual-jaw configurations.
• Achieved Area-Under-the-Curve (AUC) ≥ 0.94 for detecting conductivity contrasts (≥30%) in agar-gel phantoms.
• Obtained an AUC of 0.80 for bovine tissue samples, demonstrating practical applicability.

Conclusions:

• The developed stapler+EIT algorithm is effective and accurately reconstructs tissue properties.
• This integrated system represents a significant advancement for surgical margin assessment.
• Further development of stapler+EIT technology holds promise for improving surgical outcomes.