1. The Main Project Objective. Electrosurgery has become the leading surgical technique due to its low cost, adaptability, and capability for simultaneous cutting and hemostasis. However, at present surgeon maintains fixed mode and power level, routinely exceeding the required minimum. This gives rise to tissue charring, necrosis, and excessive voltage prone to cause injuries. The broad objective of this project is to mitigate the adverse consequences of a priori fixing mode/power, especially in laparoscopic and robotic setting, through enabling a paradigm shift - from surgeon-centric to tissue-centric. The latter consists in adaptively optimizing the actual operating conditions for maximum tissue benefit, while autonomously transitioning between modes, instead of holding the preset cut, mixed, or coagulation mode and its power. 2.
Specific Aims. To enable the novel paradigm, specific aims consist in 1) developing i) multiscale control/display-oriented surgically-relevant tissue models through mutually reinforced first-principles and Al/data-driven formalisms, ii) multimodal software-sensor-based tissue-centric sensing, and iii) multiscale network adaptive tissue-centric control algorithms; 2) integrating them into a coherent cyber-physical design paradigm and constructing, on its basis, a multifunctional electrosurgical tool; 3) enabling a tissue-aware operating surgeon interface via real-time visual tissue status streaming, and 4) extensively testing resulting electrosurgical setting on perfused tissue . 3. Relevance to BIMIT Mission. The project integrates physical, engineering, and life sciences to improve medical care through developing electrosurgical paradigm for maximum tissue/patient benefit. 4. Research Design and Methods. 1) advance precarbonization sensing both fundamentally and technically, 2) design and implement a real-time multi-modal (thermal/vision/spectroscopic) sensor array that characterizes onset of the tissue condition corresponding to each of the modes, 3) in place of a single monopolar probe, design and build a fused array of flexible isolated electrodes to form a reconfigurable multi-arcing spatially-mixed-mode thermogeometric footprint, 4) develop software to aggregate fused probe and multi-modal sensor array into a hierarchical evolving structure to deliver the real-time-optimized thermogeometrically adaptable electrosurgical footprint through closed-loop individual mode selection /power regulation in each microprobe, 5) develop software for tissue-aware surgeon interface.
The project strives towards attaining electrosurgical action with the maximum tissue benefit: minimum tissue charring, necrosis, excessive removal, malignant tissue disturbance, burn injury at the grounding pad, sepsis avoidance, and surgery time under anesthetic. The tools developed will provide a cumulative benefit of improving surgery outcome and reducing patient mortality.
