Individual customization strategy accomplished by developing prototype of a laparoscopic forceps handle using additive manufacturing

Abstract

Purpose Laparoscopic surgeons suffer because of discomfited body posture while performing surgery and experience discomfort owing to lack of customized surgical instruments. Accordingly, this paper aims to recommend an individual customization strategy by developing an ergonomically designed laparoscopic forceps handle and thereby increase the comfort of surgeons. Design/methodology/approach Hand anthropometric parameters of 282 south Indian male subjects are used to customize the handle. uPrint and Objet260 Connex, which works based on fused deposition modeling and PolyJet, respectively, are used to fabricate the prototype of the handle. Design modifications include a pistol-type grip, the increased contact area between the hand and handle, and neutral wrist posture. Findings Ergonomic evaluation parameters such as grip, functionality, comfort and wrist posture using subjective ratings from laparoscopic surgeons were recorded and obtained average values of 4.1, 3.6, 4.1 and 4.1, respectively, based on a five-point ordinal scale. Additionally, stress analysis also confirms the safety of the handle based on von Mises stress criteria. Research limitations/implications Anthropometric data are limited to 282 subjects and subjective evaluation is conducted using a prototype, not the end-use product. Originality/value Evaluation using subjective rating confirms the ascendancy of a modified handle over the existing handle in terms of assessed parameters. The proposed individual customization strategy can be applied for other industrial hand tools to enhance comfort.

Does surgeon sex and anthropometry matter for tool usability in traditional laparoscopic surgery? A systematic review and meta-analysis

“…All these measurement methods appeared to be relevant and appropriately controlled. Seven studies utilized questionnaires to refine tool handle prototypes [ 54 , 55 , 57 , 62 , 65 , 66 , 68 ]; by nature these studies contained more subjectivity. There was no concern about adherence to an experimental condition because in most studies participants were grouped based on inherent qualities, rather than an applied intervention.…”

“…Du et al [ 55 ], Kono et al [ 62 ], Matern and Waller [ 63 ], Sreekanth et al [ 65 , 66 ], and Sun et al [ 68 ] presented handle prototypes based on anthropometry and ergonomic considerations. These authors had different design priorities, as summarized in Table 2 .…”

“…Some overarching themes that existed across studies were to reduce the weight and size of the tool, allow adjustments or customization to fit the user’s hand size, and restore a neutral wrist position. Only Du et al [ 55 ], Sreekanth et al [ 66 ], and Sun et al [ 68 ] presented results regarding the difference between their prototype and existing tool handles. Du et al [ 55 ] demonstrated that their refined prototype performed equally well regarding task time and performance, while reducing the muscle load on the trapezius and increasing satisfaction compared to a similar commercial product.…”

“…Du et al [ 55 ] demonstrated that their refined prototype performed equally well regarding task time and performance, while reducing the muscle load on the trapezius and increasing satisfaction compared to a similar commercial product. Sreekanth et al [ 66 ] administered a five-point Likert scale survey to 80 participants and found an average increase in perceived grip, functionality, comfort and wrist posture of 1.5–2.3 points. It should be noted that only male surgeons participated in this study.…”

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

“…In addition, AM enables the production of personalized items at no extra cost [23,24]. Ranganathan et al [25] 3D-printed customized forceps handles based on eight anthropometric hand parameters of Indian males. González et al [26,27] presented and tested the design of an ergonomic pistol-grip handle that was customized to the surgeon's specific hand size.…”