New Ergonomic Design Criteria for Handles of Laparoscopic Dissection Forceps

Faculty of Design, Engineering and Production, Subfaculty Industrial Design Engineering, Delft University of Technology, The Netherlands.
Journal of Laparoendoscopic & Advanced Surgical Techniques (Impact Factor: 1.34). 03/2001; 11(1):17-26. DOI: 10.1089/10926420150502896
Source: PubMed

ABSTRACT The shape of laparoscopic instrument handles can cause physical discomfort. This problem may be ascribed to a lack of standards for instrument design. In this study, new ergonomic requirements for the design of laparoscopic dissection forceps were created. Three representative handles (a Karl Storz [click-line] scissors handle, an Access Plus scissors handle, and an Aesculap cylindrical handle) currently available on the market were evaluated according to the new list of ergonomic criteria.
The handles were subjectively (questionnaire) and objectively (video analyses) tested in order to find out whether the new requirements are valid for the evaluation and design of instrument handles.
The outcome of the subjective and objective tests matched the predictions by the new criteria list. New criteria were introduced (neutral wrist excursions), and existing general criteria were specified (e.g., a minimal contact area of 10 mm). Significant differences were found among the three handles. The Storz handle met 8 of the 10 requirements, the Access handle met 5, and the Aesculap handle met only 4.
The new list of ergonomic requirements is a valid tool to determine the ergonomic value of a handle for laparoscopic dissecting tasks. It gains its strength from its specialized character. Significant differences were found among the three tested handles. Cylindrical handles were inferior to scissors handles.

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Available from: Richard Goossens, Feb 04, 2015
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    • "Additionally, studies with tasks performed in a surgical trainer have reported higher workloads for surgical residents (Brown- Clerk et al, 2011; McCrory et al., 2012). These conditions have even been linked to long term damage for the surgeon (Berguer et al., 1997; Berguer, 1998a; Berguer et al., 1998b; Berguer et al, 1999; Berguer et al., 2001a; Berguer et al., 2001b; Emam et al., 2001; Van Veelen et all, 2001; Arora et al., 2010). This discomfort is in part due to the instruments (Lowndes et al., 2014). "
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    10/2014; 58(1):1280-1284. DOI:10.1177/1541931214581267
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    • "As the complaints grew, an increasing number of researchers have focused on ergonomic problems in the OR. In 2001–2003, van VMA et al. [5], [6], [8], [14], in the faculty of industrial design engineering at Delft University of Technology, gradually developed a series of guidelines for surgeons to reduce the risk of laparoscopic injury. Nevertheless, more and more cases of occupational injury among laparoscopic surgeons have been reported. "
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    PLoS ONE 07/2013; 8(7):e70423. DOI:10.1371/journal.pone.0070423 · 3.23 Impact Factor
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    • "Overall, physical ergonomic issues have been identified in the operating room environment: the operating room table height, width and adjustability (Albayrak et al., 2004; Kranenburg & Gossot, 2004; Matern & Koneczny, 2007; Van Veelen,, Jakimowicz, & Kazemier, 2004), OR lights and lighting (Kaya et al., 2008; Matern & Koneczny, 2007), floor space and layout of ORs (Albayrak et al., 2004; Decker & Bauer, 2003; Kaya et al., 2008; Koneczny, 2009; Kranenburg & Gossot, 2004), trip hazard from cables (Koneczny, 2009; Matern & Koneczny, 2007), and monitor placement (Albayrak et al., 2004; Berguer, 1999; Decker & Bauer, 2003; Kaya et al., 2008; Matern & Koneczny, 2007; Van Veelen et al., 2001); Lin et al., 2007;. There has also been work examining the tools provided in the OR, especially those for minimally invasive or laparoscopic surgery: instruments (Kaya et al., 2008; Matern, 2001; Nguyen et al., 2001; Sheikhzadeh et al., 2009; Trejo et al., 2006; Trejo et al., 2007; Van Veelen et al., 2001), instrument carts (Albayrak et al., 2004; Sheikhzadeh et al., 2009), and foot pedals (Kranenburg & Gossot, 2004; Van Veelen et al., 2001). In addition, work has continued on identifying and quantifying the negative effects experienced by surgical team members as a result of the postures adopted during procedures (Albayrak et al., 2007; Kranenburg & Gossot, 2004; Matern & Koneczny, 2007), which can result in pain or work related musculoskeletal disorders (Forst, Friedman, & Shapiro, 2006; Gerbrands, Albayrak, & Kazemier, 2004; Kaya et al., 2008; Koneczny, 2009; Nguyen et al., 2001; Park et al., 2010; Sheikhzadeh et al., 2009). "
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