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Enhancing Intraoperative Tissue Identification: Investigating a Smart Electrosurgical Knife's Functionality During
Objective:
Detecting the cancerous growth margin and achieving a negative margin is one of the challenges that surgeons face during cancer procedures. A smart electrosurgical knife with integrated optical fibers has been designed previously to enable real-time use of diffuse reflectance spectroscopy for intraoperative margin assessment. In this paper, the thermal effect of the electrosurgical knife on tissue sensing is investigated.
Methods:
Porcine tissues and phantoms were used to investigate the performance of the smart electrosurgical knife after electrosurgery. The fat-to-water content ratio (F/W-ratio) served as the discriminative parameter for distinguishing tissues and tissue mimicking phantoms with varying fat content. The F/W-ratio of tissues and phantoms was measured with the smart electrosurgical knife before and after 14 minutes of electrosurgery. Additionally, a layered porcine tissue and phantom were sliced and measured from top to bottom with the smart electrosurgical knife.
Results:
Mapping the thermal activity of the electrosurgical knife's electrode during animal tissue electrosurgery revealed temperatures exceeding 400 °C. Electrosurgery for 14 minutes had no impact on the device's accurate detection of the F/W-ratio. The smart electrosurgical knife enables real-time tissue detection and predicts the fat content of the next layer from 4 mm ahead.
Conclusion:
The design of the smart electrosurgical knife outlined in this paper demonstrates its potential utility for tissue detection during electrosurgery.
Significance:
In the future, the smart electrosurgical knife could be a valuable intraoperative margin assessment tool, aiding surgeons in detecting tumor borders and achieving negative margins.
Insights
A smart electrosurgical knife accurately detects tissue fat content during surgery. Even after extensive use, it maintains precision, aiding surgeons in identifying tumor margins for improved cancer treatment outcomes.
Area of Science:
- Biomedical Engineering
- Surgical Technology
- Optical Spectroscopy
Background:
- Achieving negative margins during cancer surgery is challenging.
- A smart electrosurgical knife with optical fibers allows real-time margin assessment using diffuse reflectance spectroscopy.
- Investigating the thermal effects on tissue sensing is crucial for device reliability.
Purpose of the Study:
- To investigate the thermal effect of a smart electrosurgical knife on tissue sensing during intraoperative margin assessment.
- To evaluate the device's performance and accuracy after electrosurgery.
- To assess the knife's capability for real-time tissue characterization.
Main Methods:
- Utilized porcine tissues and phantoms with varying fat-to-water ratios (F/W-ratio).
- Measured F/W-ratio using the smart electrosurgical knife before and after 14 minutes of electrosurgery.
- Performed layered tissue analysis to assess depth-sensing capabilities.
Main Results:
- Electrosurgical knife temperatures exceeded 400 °C during tissue ablation.
- 14 minutes of electrosurgery did not affect the device's accurate F/W-ratio detection.
- The knife demonstrated real-time tissue detection and predicted fat content 4 mm ahead.
Conclusions:
- The smart electrosurgical knife design shows promise for intraoperative tissue detection.
- The device can reliably assess tissue characteristics even after thermal exposure.
- It has potential as a valuable tool for surgical margin assessment.
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