Assessment of joystick and wrist control in hand-held articulated laparoscopic prototypes

Abstract

BackgroundVarious steerable instruments with flexible distal tip have been developed for laparoscopic surgery. The problem of steering such instruments, however, remains a challenge, because no study investigated which control method is the most suitable. This study was designed to examine whether thumb (joystick) or wrist control method is designated for prototypes of steerable instruments by means of motion analysis.MethodsFive experts and 12 novices participated. Each participant performed a needle-driving task in three directions (right → left, up → down, and down → up) with two prototypes (wrist and thumb) and a conventional instrument. Novices performed the tasks in three sessions, whereas experts performed one session only. The order of performing the tasks was determined by Latin squares design. Assessment of performance was done by means of five motion analysis parameters, a newly developed matrix for assigning penalty points, and a questionnaire.ResultsThe thumb-controlled prototype outperformed the wrist-controlled prototype. Comparison of the results obtained in each task showed that regarding penalty points, the up → down task was the most difficult to perform.ConclusionsThe thumb control is more suitable for steerable instruments than the wrist control. To avoid uncontrolled movements and difficulties with applying forces to the tissue while keeping the tip of the instrument at the constant angle, adding a “locking” feature is necessary. It is advisable not to perform the needle driving task in the up → down direction.

An articulated handle to improve the ergonomic performance of robotic dextrous instruments for laparoscopic surgery

“…Kolwadkar et al (2011) demonstrated experimentally that a fingertipcontrolled instrument with a miniature joystick outperforms a wrist-controlled instrument on a needle driving task in conventional laparoscopy. The same conclusion was reached by Okken et al (2012). However, the latter study also showed that, in some cases, conventional straight instruments performed even better than both dextrous prototypes.…”

Handheld Devices for Laparoscopic Surgery

“…Previous research has shown that ergonomics of the instrument handle influences on the task performance achieved with articulating laparoscopic instruments [38]. In this sense, Zahrahee et al suggested that a finger-operated joystick control handle is easier to use and leads to a less fatigue than an articulating handle such as the RealHand ® [39].…”

Evaluation of the effect of a laparoscopic robotized needle holder on ergonomics and skills

“…1). A joystick has been validated as the easiest and best control mode for the end effectors [6,9]. Jaimy Ò was developed on the basis of these studies, but its impact on ergonomics and skills has never been evaluated.…”