Skip to main content

Artificial hand for minimally invasive surgery: design and testing of initial prototype

Abstract

Background

Compared with traditional open surgery, minimally invasive surgery may improve recovery and patient satisfaction while maintaining surgical principles. Laparoscopic, single incision, natural orifice, and robotic approaches hold their own appeal. However, they lack the ability to manipulate organs as easily as the human hand. Advances in minimally invasive surgical techniques require new tools with increased functionality of the end effectors. Multifunctional tools with greater dexterity than those currently available are highly desired.

Methods

To address this need, we designed, fabricated, and tested the first prototype of a laparoscopic tool that provides the dexterity of a hand. The “hand” has two jointed fingers and a jointed thumb attached to a laparoscopic sheath that can be collapsed to fit through a 12-mm trocar or small orifice. The handle provides control for three independent degrees of freedom: finger motion (bending/spreading), fingertip bending, and thumb bending. The tool can be used for pinching, grasping, and spreading motions. Furthermore, the thumb is “double jointed” so that the tool can be converted to a rake configuration to allow lifting motions. The initial prototype has been tested in a cadaver lab to demonstrate its utility.

Results

Our “lap-hand” was used to complete standard surgical tasks in a simulation device in a time comparable to open and laparoscopic approaches, including “bowel” manipulation and peg movement. Cadaver testing confirmed the ability to grasp, elevate, and move liver, stomach, colon, and small bowel in a fashion expected by the hand. No adverse events were noted, and no bowel injury or perforation resulted from over-grasping.

Conclusions

We have designed, built, and tested a first prototype of an artificial hand for minimally invasive surgery. Use of such tools could both reduce the number of hand-incisions required and potentially transition more patients to undergo their abdominal procedures laparoscopically.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Pietrabissa A, Dario P, Ferrari M, Stefanini C, Menciassi A, Moretto C, Mosca F (2002) Grasping and dissecting instrument for hand-assisted laparoscopic surgery: development and early clinical experience. Surg Endosc 16(9):1332–1335

    CAS  PubMed  Article  Google Scholar 

  2. Melzer A (1996) Endoscopic instruments: conventional and intelligent. In: Toouli J, Gossot D, Hunter JG (eds) Endosurgery. Churchill Livingstone, New York, pp 69–95

    Google Scholar 

  3. Mehta NY, Haluck RS, Frecker MI, Snyder AJ (2002) Sequence and task analysis of instrument use in common laparoscopic procedures. Surg Endosc 16(2):280–285

    CAS  PubMed  Article  Google Scholar 

  4. Morris ML, Tucker RD, Baron TH, Song LMWK (2009) Electrosurgery in gastrointestinal endoscopy: principles to practice. Am J Gastroenterol 104(6):1563–1574

    PubMed  Article  Google Scholar 

  5. Briggs J, Sauer-Budge AF, Rosen J, Lee ST, A’amar O, Bigio IJ, Sharon A (2014) Integrated device for in vivo fine needle aspiration biopsy and elastic scattering spectroscopy in pre-operative thyroid nodules. J Med Devices 8(2):021003-1–021003-6

    Article  Google Scholar 

  6. Rodriguez-Diaz E, Bigio IJ, Singh SK (2011) Integrated optical tools for minimally invasive diagnosis and treatment at gastrointestinal endoscopy. Robot Comput Integr Manuf 27(2):249–256. doi:10.1016/j.rcim.2010.06.006

    PubMed Central  PubMed  Article  Google Scholar 

  7. Frecker MI, Schadler J, Haluck RS, Culkar K, Dziedzic R (2005) Laparoscopic multifunctional instruments: design and testing of initial prototypes. JSLS 9(1):105–112

    PubMed Central  PubMed  Google Scholar 

  8. Cohn MB, Crawford LS, Wendlandt JM, Sastry SS (1995) Surgical applicators of milli-robots. J Robotic Syst 12(6):401–416

    Article  Google Scholar 

  9. O’Hanley H, Rosario M, Chen YT, Walton J, Maertens A, Rosen J Design and Testing of a three fingered flexural laparoscopic grasper. In: Proceedings of the 2011 Design of Medical Devices Conference, Minneapolis, MN, 2011

  10. Patton KT, Thibodeau GA (2009) Anatomy and physiology, 7th edn. Mosby, St Louis

    Google Scholar 

  11. Brown JD, Rosen J, Chang L, Sinanan MN, Hannaford B (2004) Quantifying surgeon grasping mechanics in laparoscopy using the Blue DRAGON system. Stud Health Technol Inf 98:34–36

    Google Scholar 

  12. Van Veelen MA, Meijer DW (1999) Ergonomics and design of laparoscopic instruments: results of a survey among laparoscopic surgeons. J Laparoendosc Adv A 9(6):481–489

    Article  Google Scholar 

  13. Buchel D, Marvik R, Hallabrin B, Matern U (2010) Ergonomics of disposable handles for minimally invasive surgery. Surg Endosc 24(5):992–1004

    CAS  PubMed  Article  Google Scholar 

  14. Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg-Chicago 132(2):200–204

    CAS  PubMed  Article  Google Scholar 

  15. Bertsimas D, Tsitsiklis J (1997) Introduction to linear optimization. Athena Scientific, Nashua

    Google Scholar 

  16. Zhonghe Y, Zhaohui L, Smith M (2001) Mechanisms and machine theory. Higher Education Press, Beijing

    Google Scholar 

Download references

Acknowledgments

We would like to thank David Chargin and Holger Wirz for helpful discussions on the engineering design. We would also like to extend our gratitude to Dmitry Nepomnayshy MD, Thomas Schnellforfer MD, Phil Codyer and David Boule of the Lahey Clinic, Burlington, Massachusetts for giving us feedback on the functionality of the lap-hand and testing it on a cadaver. The study was funded by BU-Fraunhofer Alliance for Diagnostics, Medical Devices, and Instrumentation.

Disclosures

None of the authors have any conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alexis Sauer-Budge.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rosen, J.E., Size, A., Yang, Y. et al. Artificial hand for minimally invasive surgery: design and testing of initial prototype. Surg Endosc 29, 61–67 (2015). https://doi.org/10.1007/s00464-014-3657-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-014-3657-9

Keywords

  • Laparoscopic surgical tool
  • Instrument
  • Maneuverability
  • Grasper
  • Degrees of freedom