Ergonomic evaluation of a mechanical anastomotic stapler used by Japanese surgeons

Abstract

Purpose The satisfaction rating of currently available mechanical staplers for Japanese surgeons with small hands is low. To identify the issue, we examined the relationship of hand dimensions and grip force with the operation force of a mechanical circular stapler. Methods Hand dimensions and grip force were measured in 113 Japanese surgeons (52 men and 61 women). We then evaluated the relationship between grip width and the operation force required to push the lever of the stapler, at three points on the lever, using a digital force gauge. Results The optimal grip width of the dominant hand was 62.5 ± 8.5 mm for men and 55.5 ± 5.9 mm for women (p \ 0.001). The maximum grip force of the dominant hand was 44.2 ± 6.1 kg for men and 29.7 ± 4.5 kg for women (p \ 0.001) and the maximum operation force required to push the lever 7.0, 45.0, and 73.0 mm from the end of the lever was 21.8, 28.6, and 42.4 kg, respectively. Conclusions To our knowledge, this is the first ergonomic study of a surgical stapler to be conducted in Asia. Firing the stapler by gripping the proximal side of the lever is physically impossible for most Japanese women surgeons since the required operation force exceeds the maximum grip force, which probably accounts for the stress perceived by these women.

Sensory restoration by epidural stimulation of the lateral spinal cord in upper-limb amputees

“…Similarly, to quantify the change in percept area, the mean area of the percept for each week was compared to the mean area for the previous week. The distances were converted to millimeters using the average hand length of 189 mm (as measured from the tip of the middle finger to the wrist) and average palmar area of 75 cm 2 of a human male ( Agarwal and Sahu, 2010 ; Ilayperuma et al, 2009 ; Kono et al, 2014 ; Martin and Nguyen, 2004 ; Rhodes et al, 2013 ; Zafar et al, 2017 ). All electrodes that were tested in at least two of the weeks were included in the analysis.…”

Enhancing the precision of circular stapled colorectal anastomosis: could powered stapler technology provide the solution?

“…It is logical from a tissue mechanics perspective that undue/erratic movement at the anastomotic site could result in microvascular trauma and fractures at the bowel interface, potentially compromising the anastomosis. Moreover, several previous studies have demonstrated that some surgeons are simply incapable of generating the grip-strength force required to fire circular staplers [2, 3]. Design improvements in circular stapling technology that enhance the device-to-user interface (i.e., improve handling, reduce force-to-fire requirements) whilst simultaneously addressing issues with device-to-tissue interaction (i.e., reducing unwanted movement at the anastomosis during construction) have the potential to decrease the rate of technical errors and lead to improvements in clinical outcome.…”

A novel powered circular stapler designed for creating secure anastomoses

“…Studies have shown that some surgeons are simply unable to generate the grip strength force to fire circular staplers [2,3], and this may be an important factor in the aforementioned high rate of technical errors in their use to form anastomoses. The addition of power to the circular stapler has overcome the force to fire barrier in stapling.…”

“…Since that time there has been little improvement in the circular stapler function, although changes have been made to the staples and their configuration. Surgeons continue to experience difficulty in firing the devices [2,3], and this can lead to an unacceptably high rate of technical errors with manual circular staplers [4].…”