Assessment of electrosurgical hand controls integrated into a laparoscopic grasper

Abstract

The aim of this study was to quantitatively and qualitatively determine the optimal ergonomic placement of novel electrosurgical hand controls integrated into a standard laparoscopic grasper to optimize functionality. This device will allow laparoscopic surgeons to hand-operate standard electrosurgical equipment, eliminating the use of electrosurgical foot pedals, which are prone to activation errors and cause uncomfortable body positions for the physician. Three hand control designs were evaluated by 26 participants during the performance of four basic inanimate laparoscopic electrosurgical tasks. Task completion time, actuation force, forearm electromyography (EMG) and user preference were evaluated for each hand control design. Task speed was controlled using a metronome to minimize subject variability, and resulted in no significant completion time differences between task types (P > 0.05). Hand control design 1 (CD 1) resulted in the ability to generate significantly greater actuation force for three of the four tasks (P < 0.05) with minimal forearm muscle activation. Additionally, CD 1 was rated significantly better for comfort and ease-of-use compared to the other two hand control designs (P < 0.05). As a result, CD 1 was determined to be an advantageous ergonomic design for the novel electrosurgical hand controls.

Key words::

• Laparoscopy
• ergonomics
• foot pedals
• electrosurgery
• instrument design

Acknowledgements

The authors wish to acknowledge the members of the University of Nebraska Medical Center's Center for Advanced Surgical Technology (CAST) and of the Innovative Design and Ergonomic Analysis (IDEA) Laboratory for their assistance in this study. The authors would also like to acknowledge the Nebraska Research Initiative for partial support of this study.

Declaration of interest: Authors B. Brown-Clerk, J.B. Rousek, B.R. Lowndes, S.M. Eikhout, B.J. Balogh and M.S. Hallbeck have no conflicts of interest or financial ties to disclose.