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

IEEE Trans Biomed Eng. 2024 Jan;71(1):97-105. doi: 10.1109/TBME.2023.3292541. Epub 2023 Dec 22.

Abstract

Objective: This study explores the feasibility of coupling Electrical Impedance Tomography (EIT) to a standard-of-care laparoscopic surgical stapler, stapler+EIT, with the long-term goal of enabling intraoperative tissue differentiation for tumor margin detection.

Methods: Two custom printed-circuit-board-based electrode arrays with 60 and 8 electrodes, respectively, matching the stapler geometry, served as the jaws of an electrode-integrated surrogate stapler+EIT device. The device was evaluated through a series of simulations and bench-top imaging experiments of agar-gel phantoms and bovine tissue samples to evaluate the technique and determine optimal imaging parameters.

Results: Electrodes localized to only one jaw (the 60-electrode side) of the stapler outperformed a dual-jaw distribution of electrodes. Using this one-sided electrode array, reconstructions achieved an Area-Under-the-Curve (AUC) ≥ 0.94 for inclusions with conductivity contrasts of ≥30% for any size considered on measured agar-gel tests, and an AUC of 0.80 for bovine tissue samples.

Conclusion: A stapler+EIT algorithm has been tuned and evaluated on challenging phantom tests and demonstrated to produce accurate reconstructions.

Significance: This work is an important step in the development of a surgical stapler+EIT technique for margin assessment.

MeSH terms

  • Agar
  • Animals
  • Cattle
  • Electric Impedance
  • Electrodes
  • Surgical Staplers*
  • Tomography* / methods
  • Tomography, X-Ray Computed

Substances

  • Agar