Freely Movable Armrest for Microneurosurgery: Technical Note

Osaka Medical College, Takatuki, Ōsaka, Japan
Neurosurgery (Impact Factor: 3.62). 06/2000; 46(5):1259-61. DOI: 10.1097/00006123-200005000-00049
Source: PubMed


To introduce an armrest that can move freely and can promptly be fixed at any desired position during surgery.
We developed a surgical armrest system that incorporates a mechanical arm, equipped with a ball joint, which can be fixed by frictional resistance. The mechanical arm moves freely as compressed air is applied. As the button switch below the armrest is pressed while the armrest is being held (grip switch), the mechanical arm can move freely to the desired position. The mechanical arm is locked in position as soon as the button is released.
The stability of the surgeon's hands was markedly increased, and fatigue was markedly decreased, during surgery conducted using this armrest system. The system was used for 60 operations in 6 months without any problems.
The freely movable armrest is useful for neurosurgical procedures that require agility and fine movements of the hand.

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  • Neurosurgery 01/2001; 47(6):1473. DOI:10.1097/00006123-200012000-00064 · 3.62 Impact Factor
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    ABSTRACT: The study sought to determine whether the support provided by armrests influenced task quality, task efficiency, and surgeon comfort during laparoscopic surgery. Complex laparoscopic surgery requires precise movements, and usually long execution times and an uncomfortable stance. Discomfort in the shoulders, back, and neck is an established complaint among laparoscopic surgeons and is related to the unnatural postures adopted during laparoscopic interventions. Discomfort, and the associated fatigue, is a contributory factor in the execution of errors. Nineteen subjects completed a bimanual simulated laparoscopic task both with and without the aid of bilateral armrests. The task was completed in both an ideal unstressed posture and an uncomfortable, stressed elevated posture that more closely represents real laparoscopic operating conditions. Task duration was prolonged sufficiently to precipitate muscular fatigue. The participants also completed a visual analogue scale instrument on level of discomfort symptoms experienced in every part of the upper limbs and vertebral spine. Execution errors (task quality) and completion times (task efficiency) were recorded automatically by the laparoscopic simulator. Error rates and discomfort measures were significantly improved when the armrests were used, but there was no significant change in task completion time. The use of armrests in simulated laparoscopic surgery brings measurable comfort and task performance benefits, which could transfer to actual surgical procedures.
    Annals of Surgery 04/2006; 243(3):329-33. DOI:10.1097/01.sla.0000201481.08336.dc · 8.33 Impact Factor
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    ABSTRACT: BACKGROUND: Continuous precise motions are required in microneurosurgery to provide high-quality surgical results. Stabilizing the surgeon’s arm and reducing fatigue during surgery are expected to improve the precision of microsurgical procedures. We have developed an intelligent armrest, EXPERT, that follows the surgeon’s hand and fixes at an adequate position automatically using robotics technology. OBJECTIVE: To understand the feasibility of EXPERT by using the system in laboratory experiments and clinical situations. METHODS: EXPERT has an arm holder and acts as a passive controlled robot with 5 degrees of freedom. The system has 3 modes: transfer, arm-holding, and arm-free mode, which are selected automatically. In the transfer mode, the arm holder follows the surgeon’s arm. In the arm-holding mode, EXPERT supports the surgeon’s arm weight by fixing the arm holder. The surgeon can move his/her arm away from the arm holder in the arm-free mode. The surgeon can change the position of armrest while looking through the microscope and can continue the microsurgical procedure while holding surgical instruments. Since 2010, EXPERT has been applied in 13 surgeries. RESULTS: The EXPERT system decreased surgeon fatigue and reduced difficulty in performing surgical procedures. The EXPERT system markedly reduced surgeon hand tremor. There were no complications related to the use of this system. CONCLUSION: EXPERT is a useful tool for holding the surgeon’s arm comfortably and following the surgeon’s arm automatically. ABBREVIATION: FMA, freely movable armrest
    Neurosurgery 01/2013; 72:A39-A42. DOI:10.1227/NEU.0b013e318271ee66 · 3.62 Impact Factor
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