Rolling Mechanical Imaging for Tissue Abnormality Localization During Minimally Invasive Surgery

We describe a novel approach for the localization of tissue abnormalities during minimally invasive surgery using a force-sensitive wheeled probe. The concept is to fuse the kinaesthetic information from the wheel-tissue rolling interaction into a pseudocolor rolling mechanical image (RMI) to visualize the spatial variation of stiffness within the internal tissue structure. Since tissue abnormalities are often firmer than the surrounding organ or parenchyma, a surgeon then can localize abnormalities by analyzing the image. Initially, a testing facility for validating the concept in an ex vivo setting was developed and used to investigate rolling "wheel-tissue" interaction. A silicone soft-tissue phantom with embedded hard nodules was constructed to allow for experimental comparison between an RMI and a known soft-tissue structure. Tests have also been performed on excised porcine organs to show the efficacy of the method when applied to biological soft tissues. Results indicate that the RMI technique is particularly suited to identifying the stiffness distribution within a tissue sample, as the continuous force measurement along a given rolling trajectory provides repeatable information regarding relative variations in the normal tissue response. When compared to multiple discrete uniaxial indentations, the continuous measurement approach of RMI is shown to be more sensitive and facilitates coverage of a large area in a short period of time. Furthermore, if parametric classification of tissue properties based on a uniaxial tissue indentation model is desirable, the rolling indentation probe can be easily employed as a uniaxial indenter.