InstToolsExperiments

Contents

donor: CMULTIS002
First mock of instrumented surgical tool procedures minus Vic3D strain measurement.
Cut skin 10 cm - measured length, width, depth
retracted skin 2 cm
widened incision with forceps
closed incision for approximation with forceps
everted tissue with forceps
(trial #16) closed suture with square knot at midpoint connected to scalpel bolt
(17) closed suture with a loop, no knot, take first trial not last.
(18) closed suture with surgeons knot (first knot)
(19) tied 3rd knot (second was not instrumented)
(20 & 21) tissue pulling. Not a loop like (17). tied knot to one end, pulled on other. mechanically the same as the loop, just pulled on one side instead of both.
Notes:
- finalize trial naming convention
- build in length, width, depth window after each trial
- build apparatus to hold metal ruler (use manfrotto arm)

donor: CMULTIS002 (the name was actually SMULTIS002-1 but this will be archived as mock data to leave 002 for a different donor)

Goal: Test Vic3D system integration and use during first three surgical procedures

all software and hardware modifications were made prior
Vic3D triggered at 30fps for 20s by multis computer
Synchronization signal also sent and stored with Vic3D
For each trial, a folder was created for Vic3D
An ink roller was used and worked seemingly well
Different camera angles were tested for optimal viewing and minimal tool shadowing

Notes for next time
- Create calibration folder for the day's experiment
- use for all trials that day
- tilt cameras towards operator
- move cameras closer together to reduce shadowing effect

Full data collection including strain measurement

Notes:

although DIC can only measure 4-5cm cut length, make cut full length. DIC will occur on first half, so start cut at beginning of DIC region, continue 5cm after end of DIC
do not retract after skin cut with current retractor because it is too large relative to the cut depth (0.6mm)
move the forceps wid/eve/clos and suture steps to after the cut through skin fat interface so that more tissue is available. The forceps will essentially be grabbing the skin plus skin/fat interface
for retraction, start at midline and continue to retract 1cm after contact
subtract ruler thickness from caliper depth measurement

First non-mock experiment

Protocol Deviations
Specimen underwent 1 extra freeze thaw cycle due to software malfunction on first attempted experiment
To reduce reflection during indentation the polarized VIC3d light filters were first optimized to the undeformed skin, then rotated 90 degrees. This method will be used from now on.
A shadow not visible to the naked eye blocked VIC3d strain measurement of the cut trial. A mock cut will be performed from now on.
Extra force/moment data was collected at the beginning of each trial. A series of tap tests were conducted to show that the extra data is exactly the length of the difference between the force data time (~13s) and optotrak data time (~10s). The last 10s of each optotrak and force are synchronized by removing that difference.

donor: CMULTIS006 date: 09-21-18
Protocol Deviations
some missing optotrak data (beginning only) for trial 017 (cutting fat muscle interface)

donor: CMULTIS009 date: 10-17-18
Protocol Deviations
SXX_CUT_FAT
- Just over half the length of the cut penetrated the muscle fascia below
- SXX_CUT_FMI was therefore not possible and not collected following the SXX_CUT_FAT trial.
- The remaining fascia and roughly 3mm (depth) of muscle was cut but not recorded to prepare the tissue for the muscle retraction trial.
Notes
Possibly best VIC3D yet for each of the three trials

donor: CMULTIS010 date: 10-18-18
Notes
VIC3D results for all three trials comparable to 009.
Tissue recovered atypically well during indentation, likely due to excess and relatively young subcutaneous tissue

donor: CMULTIS011 date: 10-30-18
Notes
VIC3D cut terial was not the best. Tissue was not dark or light. Both white and black speckle was attempted
This specimen underwent one less freeze-thaw cycle and was kept thawed one day less than others. The Ultrasound and Surgical Tools and CT/MRI were all completed in one day.
Analysis:
- Trial 021 - missing Optotrak data in the middle of the dissection. Trial not repeated since dissection is destructive.