ORIGINAL RESEARCH

Instrumental palpation in endoscopic renal surgery: case reports and analysis

Solodova RF1, Tolstykh MP2, Isaev TK3, Trushkin RN3, Vtorenko VI3, Staroverov VM1, Sokolov ME1
About authors

1 Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow

2 Evdokimov Moscow State University of Medicine and Dentistry, Moscow

3 City Clinical Hospital №52, Moscow Health Department, Moscow

Correspondence should be addressed: Rozaliya F. Solodova
Leninskie gory 1, build. 46, Moscow, 119991; gro.vodolos@ayilazor

About paper

Funding: the work was done with the financial support of the Russian Science Foundation (project No. 16-11-00058 “Development of methods and algorithms for automated medical tactile information analysis and tactile image classification”).

Acknowledgments: the authors thank Galatenko A.V. and Galatenko V.V. (Lomonosov Moscow State University) for valuable comments, criticism, and help with preparing the manuscript.

Received: 2018-07-26 Accepted: 2018-11-23 Published online: 2018-12-16
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Palpation is one of the classic examination methods in open surgeries. In minimally invasive surgery, intra-operational manual palpation is impossible to use for assessing tactile characteristics of tissues. In Russia, the only available instrument for intra-operational assessment and objective registration of tissue visco-elastic properties is the Medical Tactile Endosurgical Complex (MTEC). The aim of this work was to study the performance of MTEC in renal surgery. The study was performed during nine elective laparoscopic surgeries for clear cell renal carcinoma and simple renal cysts. We have found several differences in the use of MTEC in renal surgery, as compared to its use in gastrointestinal or lung surgeries. The key factor determining these differences was the inverse relations between tissue visco-elastic properties: the studied tumors were softer than the surrounding tissue. Detection of intraparenchymal tumors by tactile methods was impossible. For surface tumors, in one case out of nine it was possible to strictly locate the border of the tumor by tactile examination. We were able to quantitatively assess and determine the difference in hardness of tumors and intact tissue using MTEC. This allows studying the prognostic value of objectively registered tactile characteristics of renal tumors.

Keywords: renal surgery, instrumental mechanoreceptoric palpation, objective registration of tactile images, Medical Tactile Endosurgical Complex (MTEC), clear cell renal carcinoma, renal cyst

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