The optimal mechanical efficiency of laparoscopic forceps

Heijnsdijk, Eveline A.M.; Pasdeloup, A.; Dankelman, Jenny; Gouma, Dirk J.

doi:10.1007/s00464-004-9000-0

Cited by 24 publications

(15 citation statements)

References 10 publications

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“…These values are averages calculated for grasps maintained for 4 s. The results of the measurement of the grasping force achieved using the handpiece are shown in Figure 7. A previous study concluded that the pinch force necessary to avoid slippage is more than 3.3 N [12]. Because the forceps was able to produce grasping forces of more than 3.3 N with both the motor drive and the handpiece, we conclude that the forceps produces sufficient grasping force for it to be used in practical applications.…”

Section: Results Of Grasping Force Measurement Experimentsmentioning

confidence: 59%

Two-way least-incision transformable end-effector forceps for robot-assisted surgery

Yamamoto

Nakamura

2015

Robomech J

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In laparoscopic surgery, smaller incisions produce good clinical results for patients. Therefore, there is a great need to develop thinner instruments for use in laparoscopic surgery. However, thinner instruments have smaller end effectors that limit the functionality of the instruments. To address this problem, we previously developed a new type of forceps that uses a least-incision transformable end-effector (LITE) mechanism for graspers of two sizes (i.e., a two-way LITE mechanism), which decreases the instrument exchange frequency and the total procedure time during surgery. Robot-assisted surgery is currently receiving considerable attention. However, instrument exchange during robot-assisted surgery is complicated. The purpose of this study was to develop a new two-way LITE forceps that would be suitable for use in robot-assisted surgery and laparoscopic surgery by being attached to a handpiece to reduce the time and difficulty associated with the instrument exchange during robot-assisted surgery. The experimental results show that the proposed forceps can reduce the total instrument exchange time in a simulated robot-assisted surgery environment, generate sufficient grasping forces to serve as a laparoscopic grasper, and perform switching between its small-grasper and large-grasper modes when operated with one hand using the handpiece. An in vivo experiment was performed on a pig under simulated surgery conditions to evaluate the usefulness of the prototype developed in this study. When operated with a motor drive, the forceps was able to grasp the liver using its large grasper.

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Section: Results Of Grasping Force Measurement Experimentsmentioning

confidence: 59%

Two-way least-incision transformable end-effector forceps for robot-assisted surgery

Yamamoto

Nakamura

2015

Robomech J

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“…For the offset-bending manipulator, the positional accuracy was also 0.5 mm from the forceps tip trajectory measurements. When the organ was pulled up by the manipulator, the traction force has to exceed 5 N [19]. It was con rmed that the offset angle was maintained to pull up the model organ because of the allowance for wire tension force based on the experimental results.…”

Section: Discussionmentioning

confidence: 98%

“…Based on these results, further improvements are being planned to develop the offset-bending manipulator for clinical use. First, the grasp and traction force must exceed 5 N [19], and the friction resistance of the transmission mechanisms should be lower. Second, an intuitive interface with 5 DOFs is necessary.…”

Section: Discussionmentioning

confidence: 99%

Bending Forceps Manipulator with Offset Distance for Single-port Laparoscopy

Kawai

Matsumoto

Nishikawa

et al. 2016

ABE

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By integrating locally operated, small surgical robots and devices, a surgeon can perform, robotically assisted laparoscopic surgery safely and accurately. However, no locally operated robotic forceps functioning as the third arm can provide the wide eld of view and the large working area required for single-incision laparoscopic surgery (SILS). For SILS using a locally operated third arm, the pivot point should be placed far from the other three instruments inserted through the single port, and the pivot axes should be bending. Size reduction of the differential geared mechanism is dif cult. Designing bending pivot axes for the exible worm mechanism is also dif cult. Bending pivot axes are also dif cult to achieve in the crank-curved manipulator that we proposed previously as the second arm. The crank distance is short because of the high-step cylinders. The curved forceps have low accuracy because of rubber deformation. In the present study, we modi ed the crank-curved manipulator and designed a new manipulator for use as the third arm in a sterile environment, which provides offset distance using lowstep cylinders in the pivot point placed far from the other instruments, as well as bending forceps mechanisms using ball joints in the bending pivot axes. We succeeded to develop a bending forceps manipulator with offset distance as a locally operated, end-effector manipulator (offset LODEM) for use as the third arm. The operating range was 60 mm for the offset, 32 for the pitch and yaw axes, and 24 mm for the insertion/extraction axis. Positional accuracy was evaluated while performing a simulated surgical procedure. The accuracy was 0.5 mm, which is suf cient for handling organs. The manipulator successfully handled the target in the simulated surgical procedures to provide a wide eld of view and a large working area. The offset LODEM was designed to allow minimally invasive, robotically assisted surgery performed by a doctor working near the patient. This device may be used for such applications.

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“…Heijnsdijk et al [22] evaluated the effects from differences in the force transmission ratios of laparoscopic forceps and concluded that the efficiency is dependent on the task being performed. Whereas a low force transmission ratio is sufficient for tasks requiring little movement of the forceps, such as grasping and holding tissue, a high force transmission ratio is required for tasks requiring repeated movement of the forceps.…”

Section: Discussionmentioning

confidence: 99%