Evaluation of Instrument Dexterity and Static Resistance of Laparoendoscopic Single-Site (LESS) Surgical Ports

Adam E. de Laveaga, Bernadette McCrory, Chad A. LaGrange, Susan Hallbeck

Research output: Contribution to journalArticle

Abstract

There is a lack of data on instrument dexterity and interface resistance with respect to the emerging surgical technology of LESS ports. A comparative analysis was conducted to characterize the force to maneuver laparoscopic instruments at various working angles within three commercially available LESS ports. A novel test fixture was created where working angles of the instruments were systematically varied in both the horizontal and sagittal plane within synthetic skin and rigid inserts. Two standard 5-mm laparoscopic graspers and a 10-mm simulated laparoscope were inserted into the trocars of the SILS™, TriPort™ and GelPOINT™ LESS ports. The positions of the laparoscope and grasper (G1) were fixed, while the working instrument's position (G2) was systematically varied to create a range-of-motion. The static force required to maintain a specific position for G2 was measured using a digital force gauge for that range-of-motion. The resistance created by each LESS port was most noticeable at greater separation angles. The GelPOINT™ provided the least resistance to instrument movement; while the TriPort™ required the greatest amount of force at all angular positions. The 15-mm skin interface yielded lower overall resistance for all ports compared to the 30-mm skin interface. Resistance created by each LESS port increased with greater angular separation. Increased thickness and rigidity of the abdominal wall resulted in greater static forces and reduced instrument range-of-motion for all surgical ports. LESS port design and geometry heavily influenced overall instrument range-of-motion, as well as the resistance found at extreme separation angles. Surgeons should consider the degree of instrument motion required specific to the procedure being performed when selecting a LESS port.

Original languageEnglish (US)
Article number021002
JournalJournal of Medical Devices, Transactions of the ASME
Volume6
Issue number2
DOIs
StatePublished - Apr 5 2012
Externally publishedYes

Fingerprint

Articular Range of Motion
Laparoscopes
Skin
Laparoscopy
Abdominal Wall
Surgical Instruments
Technology
Rigidity
Gages
Geometry

ASJC Scopus subject areas

  • Biomedical Engineering
  • Medicine (miscellaneous)

Cite this

Evaluation of Instrument Dexterity and Static Resistance of Laparoendoscopic Single-Site (LESS) Surgical Ports. / de Laveaga, Adam E.; McCrory, Bernadette; LaGrange, Chad A.; Hallbeck, Susan.

In: Journal of Medical Devices, Transactions of the ASME, Vol. 6, No. 2, 021002, 05.04.2012.

Research output: Contribution to journalArticle

@article{0f5a0b4cb0834a45b44ad662990a62e8,
title = "Evaluation of Instrument Dexterity and Static Resistance of Laparoendoscopic Single-Site (LESS) Surgical Ports",
abstract = "There is a lack of data on instrument dexterity and interface resistance with respect to the emerging surgical technology of LESS ports. A comparative analysis was conducted to characterize the force to maneuver laparoscopic instruments at various working angles within three commercially available LESS ports. A novel test fixture was created where working angles of the instruments were systematically varied in both the horizontal and sagittal plane within synthetic skin and rigid inserts. Two standard 5-mm laparoscopic graspers and a 10-mm simulated laparoscope were inserted into the trocars of the SILS™, TriPort™ and GelPOINT™ LESS ports. The positions of the laparoscope and grasper (G1) were fixed, while the working instrument's position (G2) was systematically varied to create a range-of-motion. The static force required to maintain a specific position for G2 was measured using a digital force gauge for that range-of-motion. The resistance created by each LESS port was most noticeable at greater separation angles. The GelPOINT™ provided the least resistance to instrument movement; while the TriPort™ required the greatest amount of force at all angular positions. The 15-mm skin interface yielded lower overall resistance for all ports compared to the 30-mm skin interface. Resistance created by each LESS port increased with greater angular separation. Increased thickness and rigidity of the abdominal wall resulted in greater static forces and reduced instrument range-of-motion for all surgical ports. LESS port design and geometry heavily influenced overall instrument range-of-motion, as well as the resistance found at extreme separation angles. Surgeons should consider the degree of instrument motion required specific to the procedure being performed when selecting a LESS port.",
author = "{de Laveaga}, {Adam E.} and Bernadette McCrory and LaGrange, {Chad A.} and Susan Hallbeck",
year = "2012",
month = "4",
day = "5",
doi = "10.1115/1.4006130",
language = "English (US)",
volume = "6",
journal = "Journal of Medical Devices, Transactions of the ASME",
issn = "1932-6181",
publisher = "American Society of Mechanical Engineers(ASME)",
number = "2",

}

TY - JOUR

T1 - Evaluation of Instrument Dexterity and Static Resistance of Laparoendoscopic Single-Site (LESS) Surgical Ports

AU - de Laveaga, Adam E.

AU - McCrory, Bernadette

AU - LaGrange, Chad A.

AU - Hallbeck, Susan

PY - 2012/4/5

Y1 - 2012/4/5

N2 - There is a lack of data on instrument dexterity and interface resistance with respect to the emerging surgical technology of LESS ports. A comparative analysis was conducted to characterize the force to maneuver laparoscopic instruments at various working angles within three commercially available LESS ports. A novel test fixture was created where working angles of the instruments were systematically varied in both the horizontal and sagittal plane within synthetic skin and rigid inserts. Two standard 5-mm laparoscopic graspers and a 10-mm simulated laparoscope were inserted into the trocars of the SILS™, TriPort™ and GelPOINT™ LESS ports. The positions of the laparoscope and grasper (G1) were fixed, while the working instrument's position (G2) was systematically varied to create a range-of-motion. The static force required to maintain a specific position for G2 was measured using a digital force gauge for that range-of-motion. The resistance created by each LESS port was most noticeable at greater separation angles. The GelPOINT™ provided the least resistance to instrument movement; while the TriPort™ required the greatest amount of force at all angular positions. The 15-mm skin interface yielded lower overall resistance for all ports compared to the 30-mm skin interface. Resistance created by each LESS port increased with greater angular separation. Increased thickness and rigidity of the abdominal wall resulted in greater static forces and reduced instrument range-of-motion for all surgical ports. LESS port design and geometry heavily influenced overall instrument range-of-motion, as well as the resistance found at extreme separation angles. Surgeons should consider the degree of instrument motion required specific to the procedure being performed when selecting a LESS port.

AB - There is a lack of data on instrument dexterity and interface resistance with respect to the emerging surgical technology of LESS ports. A comparative analysis was conducted to characterize the force to maneuver laparoscopic instruments at various working angles within three commercially available LESS ports. A novel test fixture was created where working angles of the instruments were systematically varied in both the horizontal and sagittal plane within synthetic skin and rigid inserts. Two standard 5-mm laparoscopic graspers and a 10-mm simulated laparoscope were inserted into the trocars of the SILS™, TriPort™ and GelPOINT™ LESS ports. The positions of the laparoscope and grasper (G1) were fixed, while the working instrument's position (G2) was systematically varied to create a range-of-motion. The static force required to maintain a specific position for G2 was measured using a digital force gauge for that range-of-motion. The resistance created by each LESS port was most noticeable at greater separation angles. The GelPOINT™ provided the least resistance to instrument movement; while the TriPort™ required the greatest amount of force at all angular positions. The 15-mm skin interface yielded lower overall resistance for all ports compared to the 30-mm skin interface. Resistance created by each LESS port increased with greater angular separation. Increased thickness and rigidity of the abdominal wall resulted in greater static forces and reduced instrument range-of-motion for all surgical ports. LESS port design and geometry heavily influenced overall instrument range-of-motion, as well as the resistance found at extreme separation angles. Surgeons should consider the degree of instrument motion required specific to the procedure being performed when selecting a LESS port.

UR - http://www.scopus.com/inward/record.url?scp=84859592964&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859592964&partnerID=8YFLogxK

U2 - 10.1115/1.4006130

DO - 10.1115/1.4006130

M3 - Article

AN - SCOPUS:84859592964

VL - 6

JO - Journal of Medical Devices, Transactions of the ASME

JF - Journal of Medical Devices, Transactions of the ASME

SN - 1932-6181

IS - 2

M1 - 021002

ER -