Elsevier

Journal of Biomechanics

Volume 34, Issue 10, October 2001, Pages 1335-1340
Journal of Biomechanics

Technical notes
Resistance forces acting on suture needles

https://doi.org/10.1016/S0021-9290(01)00099-9Get rights and content

Abstract

Understanding the resistance forces encountered by a suture needle during tissue penetration is important for the development of robotic surgical devices and virtual reality surgical simulators. Tensile forces applied to skin and tendon during suturing were measured. Fresh sheep achilles tendons were tensioned with a static load 4.9 N, 9.8 N or 19.6 N and sheepskin with 0.98 N, 2.9 N or 4.9 N static load. A straight 2/0 cutting suture needle in series with a load cell on a materials testing machine penetrated the tissue at 90° with a velocity of 1, 5 or 10 mm/s for each tissue tension (n=5). Continuous load versus displacement data was obtained and penetration load and stiffness were noted. The load versus displacement curve for skin during needle penetration demonstrated two characteristic peaks, corresponding to initial penetration and emergence of needle from the undersurface of the tissue. Increasing the tension within the tissue (skin and tendon) increased the amount of force required to penetrate the tissue with a suture needle (p<0.05). Needle displacement rate did not affect the resistance to needle penetration (p<0.05). This study provides a simple model for measuring force-feedback during needle penetration of soft tissues and is a good starting point for future studies of the penetration resistance properties of human tissues.

Introduction

Virtual reality (VR) surgical simulators are an effective educational tool (Rosen et al., 1999). Current computer generated imaging closely models the visual surgical environment, but realistic tactile and force (haptic) feedback is lacking. Improving the haptic feedback through accurate characterization of the mechanical properties of soft tissues enhances the realism and educational benefit of surgical simulators. The integration of robotic technology into the surgical environment requires accurate mathematical modelling based on mechanical testing of soft tissues (Miller and Chinzei, 1997).

The use of needles during suturing is one of the most common procedures in surgery. Previous studies have evaluated suture needle penetration, examining the effect of needle material properties and geometry on function (Towler et al., 1988; McClung et al., 1992; Edlich et al., 1990; Bendel et al., 1986). These studies focused on the mechanical properties of the needle rather than the tissue. The tissue response to loading constitutes the haptic feedback to the surgeon during suturing. In order to develop a surgical simulator with haptic fidelity, the tissue response to needle penetration forces must be characterized. This study examined the resistance forces encountered during the passage of a straight suture needle through sheepskin and sheep tendon to provide input data for haptic VR surgical simulation.

Section snippets

Method

Ethics approval was obtained for the acquisition and use of animal tissue in this study.

Results

Greater axial force was required by the surgeons during needle passage through tendon (mean 5.3 N) than through skin (mean 1.9).

Discussion

The development of virtual reality techniques and the emergence of automated surgical tools and robots has prompted research into the computer simulation of surgical procedures (Miller et al., 2000). Computer simulations rely on experimental data for their accuracy due to the high degree of variability between both types of tissue and individuals. The passage of a suture needle through soft tissue is important in VR surgical modelling of tissue behavior because it is a fundamental action in

Conclusion

The resistance forces acting on needles during suturing can be characterized. This data provides groundwork in the rapidly developing field of VR and robotic surgery, as well as providing an ergonomic analysis of the factors involved in needle penetration of skin and other soft tissues.

References (11)

There are more references available in the full text version of this article.

Cited by (83)

  • The biomechanics of autoinjector-skin interactions during dynamic needle insertion

    2022, Journal of Biomechanics
    Citation Excerpt :

    For soft tissues such as skin, there exists data on the elastic properties (Limbert, 2017). The fracture properties for skin and other soft tissues have been estimated with scissor cutting tests (Pereira et al., 1997), trouser tear tests (Rivlin and Thomas, 1953; Shergold and Fleck, 2005; Pissarenko et al., 2020), and needle insertion re-insertion tests (Frick et al., 2001; Azar and Hayward, 2008; Barnett et al., 2016). We use experimental work from needle insertion tests to validate the model before conducting an extensive parametric investigation of skin-device interaction.

View all citing articles on Scopus
View full text