Surgical Technology and Robotics Group, Institute for Medical Science and Technology, University of Dundee, 1, Wurzburg Loan, Dundee, DD2 1FD, Scotland, UK,
Surg Endosc. 2014 Apr;28(4):1277-83. doi: 10.1007/s00464-013-3323-7. Epub 2013 Dec 24.
Despite the importance of efficient grasping during laparoscopic surgery, the published literature on jaw features, e.g., fenestrations and surface profiling on grasping efficiency defined as resistance to slip without inflicting trauma, is limited.
Various surface geometries of the jaws were tested with respect to (i) inclusion of fenestrations; (ii) surface contact to fenestration area ratio, and (iii) surface profiling of the jaws. Various loads were applied to the tissue which was subsequently pulled at a constant rate until free from the jaws. The maximal force necessary to pull the tissue free was recorded. The jaws were designed for use in parallel-occlusion graspers to avoid the well documented high pinch forces encountered with pivoted occlusion.
At all applied forces the force needed to pull tissue from any fenestration design was significantly higher than the force necessary to pull tissue from non-fenestrated jaws (p < 0.05) with no significant differences between the three fenestration designs. The ratio of surface contact to fenestration area must exceed 1:0.4 to achieve a significant increase in the tissue retention. All the profiles studied were made using a single fenestration and with a surface contact to fenestration area ratio of 1:0.8. All such profile designs studied performed significantly better than the control (p < 0.005). The ratio of the mean retraction to applied force across all load conditions tested were 1.23:1.0 and 1.7:1.0 for the waved and toothed profile respectively, with standard deviations for the corresponding retraction force of ±0.45 and ±0.38 respectively.
The retention efficiency of laparoscopic graspers is improved by fenestration which must, however, exceed a certain ratio (>1.0:0.4). Likewise surface profiling of the jaws enhances retention efficiency and its design (tooth, waved, mixed) directly influences the amount of pressure needed to retain tissue.
尽管在腹腔镜手术中有效的抓握很重要，但有关颌部特征的已发表文献（例如，用于定义抗滑动而不造成创伤的抓握效率的开窗和表面轮廓）有限。
测试了各种颌部的表面几何形状，包括（i）是否存在开窗；（ii）表面与开窗面积的接触比，以及（iii）颌部的表面轮廓。将各种负载施加到组织上，然后以恒定的速率将其拉出，直到组织从颌部上完全脱落。记录将组织从颌部上完全拉出所需的最大力。颌部是为平行闭合抓握器设计的，以避免与枢轴闭合相关的高夹力问题。
在所有施加的力下，从任何开窗设计中拉取组织所需的力都明显高于从无开窗颌部中拉取组织所需的力（p < 0.05），而三种开窗设计之间没有显著差异。表面接触与开窗面积的比值必须超过 1:0.4 才能显著提高组织的保持力。研究中所有的轮廓都是使用单个开窗和表面接触与开窗面积的比值为 1:0.8 制作的。所有研究的轮廓设计都明显优于对照（p < 0.005）。在所有测试的负载条件下，平均回缩与施加力的比值分别为 1.23:1.0 和 1.7:1.0，对应的回缩力的标准差分别为±0.45 和±0.38。
通过开窗可以提高腹腔镜抓握器的保持效率，但开窗必须超过一定的比值（>1.0:0.4）。同样，颌部的表面轮廓也可以提高保持效率，其设计（齿状、波浪状、混合状）直接影响保持组织所需的压力。
