Comparative Study of the Use of Different Sizes of an Ergonomic Instrument Handle for Laparoscopic Surgery

Abstract

Previous studies have shown that the handle design of laparoscopic instruments is crucial to surgical performance and surgeon’s ergonomics. In this study, four different sizes of an ergonomic laparoscopic handle design were tested in a blind and randomized fashion with twelve surgeons. They performed three laparoscopic tasks in order to analyze the influence of handle size. Execution time, wrist posture, and finger and palm pressure were evaluated during the performance of each task. The results show a significant reduction in the time required to complete the eye-manual coordination task using the appropriate handle. The incorrectly sized handle resulted in a rise in palm pressure and a reduction in the force exerted by the thumb during the transfer task. In the hand-eye coordination task, the use of the right handle size led to an increase in middle finger pressure. In general, surgeons had an ergonomically adequate wrist flexion in all tasks and an acceptable radio-ulnar deviation during the transfer task using the ergonomic instrument handle. Surgeons found it comfortable the use of the ergonomic handle. Therefore, the use of an appropriately sized instrument handle allows surgeons to improve ergonomics and surgical performance during the laparoscopic practice.

Wearable Technology for Assessment and Surgical Assistance in Minimally Invasive Surgery

“…However, in both cases these devices are difficult to integrate into the surgical environment, and are relegated mainly to experimental studies. This technology has been used to objectively study the surgeon's wrist posture in the use of new handle designs for laparoscopic instruments [20].…”

“…In a study, we evaluated the pressure exerted by the surgeon's distal phalanges of the thumb and the index, middle and ring fingers, as well as the palm of the hand during the use of new handle designs for laparoscopic instruments and with different sizes [20]. The participating surgeons performed three laparoscopic basic tasks to analyze the influence of handle size.…”

A Fully 3D-Printed Steerable Instrument for Minimally Invasive Surgery

“…They concluded that the use of their ergonomic handle reduced muscle fatigue and improved the ease of use of the instrument. Similarly, Sánchez-Margallo et al [28] compared customized 3D-printed handles with standard handles and reported that the customized handles aided the surgeon's hand-eye coordination and led to shorter execution times.…”

Engineering-Aided Inventive Surgery

“…Anyway, the operating field in the context of synergies between engineering and surgery provides most of the advanced and promising solutions. In this regard, further interesting applications are described in the issue: from the control of MRI-compatible robots [25] and the guidance of surgical needles [26], to the use of very complex image analysis methods for surgical tool characterization [27] and the development of novel devices with high functional performances [28] and better ergonomic design for laparoscopic applications [29].…”