Feasibility of Vibroacoustic Sensing for Detection of Peritoneal Entry During Laparoscopic Access: A Pilot Study in a...

Background/Objectives: Establishing laparoscopic access remains a critical and complication-prone step in minimally invasive surgery. Previous work has shown that proximal vibroacoustic sensing can identify peritoneal puncture events in porcine cadavers. The present pilot study evaluated whether these findings translate to human anatomy under controlled, ex vivo conditions. Methods: A vibroacoustic sensing prototype was proximally attached to a standard Veress needle during 14 insertions into a fresh human body donor (within 48 h post-mortem). An endoscope was introduced laterally to provide visual ground truth of peritoneal entry. Vibroacoustic signals were recorded at the proximal end of the instrument. Time-frequency analyses, transient excitation detection, and statistical comparisons were performed to assess whether (1) peritoneal puncture can be identified in the vibroacoustic signal, (2) signal phases and dynamics correspond to those previously observed in porcine cadavers, and (3) peritoneal punctures can be statistically differentiated from non-peritoneal events. Results: All 14 peritoneal punctures were identifiable in the vibroacoustic signal under the experimental conditions. Characteristic signal phases previously described in porcine tissue, including transient excitation associated with cavity entry, were consistently reproduced with comparable temporal and spectral profiles. Statistical analyses demonstrated group-level differences between peritoneal and non-peritoneal events, and the peritoneal puncture was the highest-energy event of its insertion in 13 of 14 cases (92.9%). Conclusions: Under the controlled ex vivo conditions of this single-donor pilot study, vibroacoustic sensing was feasible for identifying peritoneal puncture in human tissue and reproduced signal dynamics observed in porcine models. To our knowledge, this is the first demonstration of the proximal vibroacoustic sensing concept on a human body donor and the first cross-species replication of the previously reported puncture phase structure, establishing an important translational stepping stone between animal cadaver studies and in vivo investigations. The study demonstrates feasibility rather than clinical reliability: the single-donor design and the retrospective annotation framework limit generalizability. Prospective validation in living patients, across multiple subjects and operators, is required before clinical deployment.