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The optimal mechanical efficiency of laparoscopic forceps

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Abstract

Background

Laparoscopic forceps have a large amount of friction in the mechanism, leading to a limited mechanical efficiency, which impairs the pinch force feedback. The advantage of a small amount of friction is that it is easier to maintain a constant pinch force on the tissue. Therefore, to obtain the optimal mechanical efficiency of the forceps, the influence of mechanical efficiency on the performance of several static and dynamic operative tasks, such as grasping tissue and estimating pressure, is quantified.

Methods

A grasper with adjustable mechanical efficiency and a load cell to measure the pinch force on the tissue was developed. Using this grasper, subjects performed several tasks on pig bowel tissue and simulation tissue: grasping tissue, reproducing a requested constant or variable pinch forces, and estimating the pressure in a tube.

Results

With increasing mechanical efficiency, a variable pinch force could be reproduced more accurately (deviation from the requested pinch force decreased from 34.4 to 24.9%, p = 0.016). The performance on the grasping tissue, reproducing a constant pinch force, and estimating pressure tasks did not improve with increased mechanical efficiency.

Conclusions

The optimal mechanical efficiency of laparoscopic forceps is dependent on the task that is performed. For tasks requiring little movement of the forceps, such as grasping and holding tissue, a low mechanical efficiency is sufficient, whereas for tasks requiring repeated movement of the forceps to feel tissue, a high mechanical efficiency is required.

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References

  1. P Breedveld HG Stassen DW Meijer JJ Jakimowicz (1999) ArticleTitleManipulation in laparoscopic surgery: overview of impeding effects and supporting aids J Laparoendosc Adv Surg Tech 9 469–480 Occurrence Handle1:STN:280:DC%2BD3c%2Fps1elug%3D%3D Occurrence Handle10.1089/lap.1999.9.469

    Article  CAS  Google Scholar 

  2. A Cuschieri (1995) ArticleTitleWhither minimal access surgery: tribulations and expectations Am J Surg 169 9–19 Occurrence Handle1:STN:280:DyaK2M7hslOltQ%3D%3D Occurrence Handle10.1016/S0002-9610(99)80104-4 Occurrence Handle7818004

    Article  CAS  PubMed  Google Scholar 

  3. H Visser Particlede EAM Heijnsdijk JL Herder PV Pistecky (2002) ArticleTitleForces and displacements in colon surgery Surg Endosc 16 1426–1430 Occurrence Handle10.1007/s00464-002-9003-7 Occurrence Handle12042911

    Article  PubMed  Google Scholar 

  4. KT Boer Particleden JL Herder W Sjoerdsma DW Meijer DJ Gouma HG Stassen (1999) ArticleTitleSensitivity of laparoscopic dissectors; what can you feel? Surg Endosc 13 869–873 Occurrence Handle10.1007/s004649901122

    Article  Google Scholar 

  5. EAM Heijnsdijk A Pasdeloup AJ Pijl Particlevan der J Dankelman DJ Gouma (2004) ArticleTitleThe influence of force feedback and visual feedback in grasping tissue laparoscopically Surg Endosc 18 980–985 Occurrence Handle1:STN:280:DC%2BD2c3ntFWmtw%3D%3D Occurrence Handle10.1007/s00464-003-9244-0 Occurrence Handle15108104

    Article  CAS  PubMed  Google Scholar 

  6. RD Howe WJ Peine DA Kontarinis JS Son (1995) ArticleTitleRemote palpation technology IEEE Eng Med Biol 14 318–323 Occurrence Handle10.1109/51.391770

    Article  Google Scholar 

  7. M Patkin L Isabel (1995) ArticleTitleErgonomics, engineering and surgery of endosurgical dissection J R Coll Surg Edinb, 40 120–132 Occurrence Handle1:STN:280:DyaK2M3psVyqug%3D%3D

    CAS  Google Scholar 

  8. J Rosen B Hannaford MP MacFarlane MN Sinanan (1999) ArticleTitleForce controlled and teleoperated endoscopic grasper for minimally invasive surgery €”experiniental performance evaluation IEEE Trans Biomed Eng 46 1212–1221 Occurrence Handle1:STN:280:DyaK1Mvkt1KitQ%3D%3D Occurrence Handle10.1109/10.790498 Occurrence Handle10513126

    Article  CAS  PubMed  Google Scholar 

  9. W Sjoerdsma JL Herder MJ Horward A Jansen JJG Bannenberg CA Grimbergen (1997) ArticleTitleForce transmission of laparoscopic grasping instruments Min Invas Ther Allied Technol 6 274–278 Occurrence Handle10.3109/13645709709153075

    Article  Google Scholar 

  10. F Tendick RW Jennings G Tharp L Stark (1993) ArticleTitleSensing and manipulation problems in endoscopic surgery: experiment, analysis, and observation Presence 2 66–81 Occurrence Handle10.1162/pres.1993.2.1.66

    Article  Google Scholar 

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Acknowledgments

The authors thank the Departments of Experimental Surgery, Experimental Cardiology, and Surgery of the Academic Medical Center Amsterdam for the use of their animals and the possibility to perform the experiments. A. J. van der Pijl, H. de Visser, J. L. Herder, J. Dukker, and A. C. van der Geest are gratefully acknowledged for designing and manufacturing the forceps.

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Authors and Affiliations

  1. Man–Machine Systems Group, Faculty of Mechanical Engineering and Marine Technology, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands

    E. A. M. Heijnsdijk & J. Dankelman

  2. Department of Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands

    E. A. M. Heijnsdijk, A. Pasdeloup & D. J. Gouma

Authors
  1. E. A. M. Heijnsdijk
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  2. A. Pasdeloup
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  3. J. Dankelman
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  4. D. J. Gouma
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Corresponding author

Correspondence to J. Dankelman.

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Heijnsdijk, E.A.M., Pasdeloup, A., Dankelman, J. et al. The optimal mechanical efficiency of laparoscopic forceps. Surg Endosc 18, 1766–1770 (2004). https://doi.org/10.1007/s00464-004-9000-0

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  • DOI: https://doi.org/10.1007/s00464-004-9000-0

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