0
Research Papers

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

[+] Author and Article Information
Adam E. de Laveaga, Bernadette McCrory

 Department of Mechanical and Materials Engineering, University of Nebraska- Lincoln, Lincoln, NE, 68588

Chad A. LaGrange

 Department of Surgery, Section of Urology, University of Nebraska Medical Center, Omaha, NE, 68198

M. Susan Hallbeck1

 Department of Mechanical and Materials Engineering, University of Nebraska- Lincoln, Lincoln, NE, 68588hallbeck@unl.edu.

1

Corresponding author. M. S. Hallbeck, Department of Mechanical and Materials Engineering, Faculty of Mechanical and Materials Engineering, University of Nebraska-Lincoln, W342 Nebraska Hall, Lincoln, NE 68588-0518.

J. Med. Devices 6(2), 021002 (Apr 06, 2012) (7 pages) doi:10.1115/1.4006130 History: Received June 12, 2011; Revised January 11, 2012; Published April 05, 2012; Online April 06, 2012

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.

FIGURES IN THIS ARTICLE
<>
Copyright © 2012 by American Society of Mechanical Engineers
Your Session has timed out. Please sign back in to continue.

References

Figures

Grahic Jump Location
Figure 5

Post-hoc test results for LESS port and insert (analysis 2)

Grahic Jump Location
Figure 6

Average force values by separation angle – analysis 1 (15-mm skin)

Grahic Jump Location
Figure 7

Average force values by separation angle – analysis 2 (30-mm skin)

Grahic Jump Location
Figure 8

Mono incision SILS

Grahic Jump Location
Figure 9

Average force values by separation angle – analysis 2 (rigid)

Grahic Jump Location
Figure 10

Port and insert behavior under moderate instrument articulation

Grahic Jump Location
Figure 11

Instrument and camera positions during LESS procedure [9]

Grahic Jump Location
Figure 4

Post-hoc test results for LESS port and insert (analysis 1)

Grahic Jump Location
Figure 3

Instrument positions & separation angle

Grahic Jump Location
Figure 2

Experimental setup

Grahic Jump Location
Figure 1

SILS™ (a), TriPort™ (b), and (c) GelPOINT™ Single-site ports [11-13]

Tables

Errata

Discussions

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In