Challenges in the Design of Laparoscopic Tools

Author(s):  
J. Amat ◽  
A. Casals ◽  
E. Bergés ◽  
A. Avilés
Keyword(s):  
2016 ◽  
Vol 84 (6) ◽  
pp. 1051-1052 ◽  
Author(s):  
Andrew C. Storm ◽  
Hiroyuki Aihara ◽  
Matthew J. Skinner ◽  
Christopher C. Thompson
Keyword(s):  

Author(s):  
Kathryn Doné ◽  
Allison DiMartino ◽  
Timothy Judkins ◽  
Susan Hallbeck ◽  
Dmitry Oleynikov
Keyword(s):  

Author(s):  
A.E. Trejo ◽  
M.-C. Jung ◽  
M.S. Hallbeck

As part of a continuous effort of reaching the optimal use of the intuitool, a study was conducted to identify the optimal diameter combination between the trackball and the end effector ball. The task was to simulate the end effector movement during an operation, using different diameter combinations. Twenty students performed the trackball-controlling tasks to move the end effector from an initial position to designated circular-shaped targets. The trackball diameters were 19 mm and 40 mm, and those of the end effector balls were 3 mm, 5 mm, and 10 mm. There were four targets: right, left, up, and down. Travel time, accuracy, and trail deviation were measured as independent variables. Accuracy was not a significant factor showing that all participants followed instructions to reach each target as accurately as possible. The time to reach the target depended both on target location and trackball to end effector ratio individually and in their interaction. It was quickest to get to the upper target compared to all other locations. Trial deviation depended only on the target position and the target location and ratio interaction. The performance of going in a straight line was best for the left and right directions as opposed to up and down using the trackball.


Author(s):  
Franz Brinkmann ◽  
Ronny Hüttner ◽  
Philipp J. Mehner ◽  
Konrad Henkel ◽  
Georgi Paschew ◽  
...  

Abstract Background Endoscopic and laparoscopic electrosurgical devices (ED) are of great importance in modern medicine but can cause adverse events such as tissue injuries and burns from residual heat. While laparoscopic tools are well investigated, detailed insights about the temperature profile of endoscopic knives are lacking. Our aim is to investigate the temperature and the residual heat of laparoscopic and endoscopic monopolar instruments to increase the safety in handling ED. Methods An infrared camera was used to measure the temperature of laparoscopic and endoscopic instruments during energy application and to determine the cooling time to below 50 °C at a porcine stomach. Different power levels and cutting intervals were studied to investigate their impact on the temperature profile. Results During activation, the laparoscopic hook exceeded 120 °C regularly for an up to 10 mm shaft length. With regards to endoknives, only the Dual Tip Knife showed a shaft temperature of above 50 °C. The residual heat of the laparoscopic hook remained above 50 °C for at least 15 s after activation. Endoknives cooled to below 50 °C in 4 s. A higher power level and longer cutting duration significantly increased the shaft temperature and prolonged the cooling time (p < 0.001). Conclusion Residual heat and maximum temperature during energy application depend strongly on the chosen effect and cutting duration. To avoid potential injuries, the user should not touch any tissue with the laparoscopic hook for at least 15 s and with the endoknives for at least 4 s after energy application. As the shaft also heats up to over 120 °C, the user should be careful to avoid tissue contact during activation with the shaft. These results should be strongly considered for safety reasons when handling monopolar ED.


Author(s):  
Nilmini Wickramasinghe ◽  
Giuseppe Turchetti ◽  
Barbara Labella ◽  
Andrea Moglia ◽  
Arianna Menciassi ◽  
...  

The generally accepted treatment for Hirschsprung’s disease is through surgical intervention. Currently, the recognized techniques include the Swenson technique, which is less frequently used as the operation is delicate and can give rise to complications; the Duhamel technique, which is arguably the simplest approach and consistently provides good results; and the Soave technique, which also provides good results but is often more complex than the Duhamel approach. However, surgical and diagnostic procedures of the future will evolve from embracing current technologies that enable minimally invasive approaches to extremely targeted, localized, and high-precision endoluminal techniques. This requires entirely new types of surgical tools capable of entering the human body through natural orifices (by insertion, ingestion, or inhalation), very small incisions (injections), or even through skin absorption and maybe configuring themselves in complex kinetic structures at the specific site of intervention. Moreover, such approaches necessitate modification of classic surgical techniques. While the advantages of minimally invasive surgery and minimally invasive therapy (MIS and MIT) are widely acknowledged, this chapter serves to highlight the advantages of such procedures in pediatric medicine, both at the diagnostic and intervention levels and the consequent implications to classic surgical techniques. The particular focus of the chapter pertains to the specific advantages the following techniques can bring into pediatric diagnostic and surgical techniques in the case of Hirschsprung’s disease: (1) endoluminal miniaturized tools for gastrointestinal endoscopy, (2) gastrointestinal capsules for digestion (e.g., M2A capsule), and (3) laparoscopic tools for surgery. Both technological and economic perspectives are discussed.


Robotica ◽  
2000 ◽  
Vol 18 (4) ◽  
pp. 347-360 ◽  
Author(s):  
Ali Faraz ◽  
Sharam Payandeh

This paper addresses the kinematic modelling, solutions and trajectory planning of a tele-laparoscopic manipulator. This type of manipulator can be used in remote positioning of laparoscopic tools through tele-operating system. Specifically the paper models kinematics of a typical manipulating system which can be used in such tele-surgery. Inverse kinematics solutions are also obtained for two kinematically constraint motions which are part of a typical trajectory of the laparoscopic tools. These are fixed axis rotation of the tool and its straight line motion. Simulation results are presented to demonstrate the validity of such models and solutions.


Author(s):  
Trejo, A.E. Jung ◽  
M.S. Hallbeck

Two laparoscopic tools, a scissor-type grasper and an ergonomically designed grasper, were compared in terms of arm posture and muscle activity during insertion into a trocar and during a standardized aiming task. Participants were asked to insert a laparoscopic tool into a simulated abdomen and hit five cross-shaped targets using their dominant hand; similar to reaching an organ during laparoscopic surgery. Twenty-six right-handed novice participants volunteered for the study. Two electrogoniometers were used to measure wrist flexion/extension, wrist deviation, and elbow flexion/extension angles. Six surface electrodes were used to measure %MVE of wrist flexors, wrist extensors, biceps brachii, triceps brachii, deltoid, and upper trapezius. The conditions used were five target positions, two touch screen monitor angles, and five hand postures. The scissors-type tool caused the largest wrist flexion, but the smallest %MVE from the wrist flexors. The method of gripping the tools was the most important factor determining joint angles and muscular load during the insertion and aiming tasks.


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