Recent Advances in Soft Biological Tissue Manipulating Technologies

Biological soft tissues manipulation, including conventional (mechanical) and nonconventional (laser, waterjet and ultrasonic) processes, is critically required in most surgical innervations. However, the soft tissues, with their nature of anisotropic and viscoelastic mechanical properties, and high biological and heat sensitivities, are difficult to manipulated. Moreover, the mechanical and thermal induced damage on the surface and surrounding tissue during the surgery can impair the proliferative phase of healing. Thus, understanding the manipulation mechanism and the resulted surface damage is of importance to the community. In recent years, more and more scholars carried out researches on soft biological tissue cutting in order to improve the cutting performance of surgical instruments and reduce the surgery induced tissue damage. However, there is a lack of compressive review that focused on the recent advances in soft biological tissue manipulating technologies. Hence, this review paper attempts to provide an informative literature survey of the state-of-the-art of soft tissue manipulation processes in surgery. This is achieved by exploring and recollecting the different soft tissue manipulation techniques currently used, including mechanical, laser, waterjet and ultrasonic cutting and advanced anastomosis and reconstruction processes, with highlighting their governing removal mechanisms as well as the surface and subsurface damages.