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Tissue quality assessment using a novel direct elasticity assessment device (the E-finger): a cadaveric study of prostatectomy dissection.

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cam.issuedOnline2014-11-10
dc.contributor.authorGood, Daniel W
dc.contributor.authorKhan, Ashfaq
dc.contributor.authorHammer, Steven
dc.contributor.authorScanlan, Paul
dc.contributor.authorShu, Wenmiao
dc.contributor.authorPhipps, Simon
dc.contributor.authorParson, Simon H
dc.contributor.authorStewart, Grant D
dc.contributor.authorReuben, Robert
dc.contributor.authorMcNeill, S Alan
dc.contributor.orcidStewart, Grant [0000-0003-3188-9140]
dc.date.accessioned2018-11-30T00:32:09Z
dc.date.available2018-11-30T00:32:09Z
dc.date.issued2014
dc.description.abstractINTRODUCTION: Minimally invasive radical prostatectomy (RP) (robotic and laparoscopic), have brought improvements in the outcomes of RP due to improved views and increased degrees of freedom of surgical devices. Robotic and laparoscopic surgeries do not incorporate haptic feedback, which may result in complications secondary to inadequate tissue dissection (causing positive surgical margins, rhabdosphincter damage, etc). We developed a micro-engineered device (6 mm2 sized) [E-finger]) capable of quantitative elasticity assessment, with amplitude ratio, mean ratio and phase lag representing this. The aim was to assess the utility of the device in differentiating peri-prostatic tissue types in order to guide prostate dissection. MATERIAL AND METHODS: Two embalmed and 2 fresh frozen cadavers were used in the study. Baseline elasticity values were assessed in bladder, prostate and rhabdosphincter of pre-dissected embalmed cadavers using the micro-engineered device. A measurement grid was created to span from the bladder, across the prostate and onto the rhabdosphincter of fresh frozen cadavers to enable a systematic quantitative elasticity assessment of the entire area by 2 independent assessors. Tissue was sectioned along each row of elasticity measurement points, and stained with haematoxylin and eosin (H&E). Image analysis was performed with Image Pro Premier to determine the histology at each measurement point. RESULTS: Statistically significant differences in elasticity were identified between bladder, prostate and sphincter in both embalmed and fresh frozen cadavers (p = < 0.001). Intra-class correlation (ICC) reliability tests showed good reliability (average ICC = 0.851). Sensitivity and specificity for tissue identification was 77% and 70% respectively to a resolution of 6 mm2. CONCLUSIONS: This cadaveric study has evaluated the ability of our elasticity assessment device to differentiate bladder, prostate and rhabdosphincter to a resolution of 6 mm2. The results provide useful data for which to continue to examine the use of elasticity assessment devices for tissue quality assessment with the aim of giving haptic feedback to surgeons performing complex surgery.
dc.format.mediumElectronic-eCollection
dc.identifier.doi10.17863/CAM.33449
dc.identifier.eissn1932-6203
dc.identifier.issn1932-6203
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286135
dc.languageeng
dc.language.isoeng
dc.publisherPublic Library of Science (PLoS)
dc.publisher.urlhttp://dx.doi.org/10.1371/journal.pone.0112872
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectCadaver
dc.subjectDissection
dc.subjectElasticity
dc.subjectHumans
dc.subjectMale
dc.subjectProstate
dc.subjectProstatectomy
dc.subjectRobotics
dc.subjectUrinary Bladder
dc.titleTissue quality assessment using a novel direct elasticity assessment device (the E-finger): a cadaveric study of prostatectomy dissection.
dc.typeArticle
dcterms.dateAccepted2014-10-15
prism.issueIdentifier11
prism.publicationDate2014
prism.publicationNamePLoS One
prism.startingPagee112872
prism.volume9
pubs.funder-project-idEngineering and Physical Sciences Research Council (EP/I020101/1)
rioxxterms.licenseref.startdate2014-01
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1371/journal.pone.0112872

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