Bosma Jesse, Aarts Sanne, Jaspers Joris
Department of Medical Technology and Clinical Physics, University Medical Center Utrecht , Utrecht , The Netherlands.
Minim Invasive Ther Allied Technol. 2015 Feb;24(1):24-30. doi: 10.3109/13645706.2014.992906.
Since the da Vinci robotic system was introduced, it has been reported to have ergonomic advantages over conventional laparoscopy (COV). High investments associated with this system challenged us to design a more economical, mechanical alternative for improvement of laparoscopic ergonomics: the Minimally Invasive Manipulator (MIM).
An earlier reported MIM prototype was investigated. Its shortcomings were input for the establishment of design criteria for a new prototype.
A new prototype was developed, aiming at improved intuitiveness and ergonomics. The handle and instrument tip were redesigned and the parallelogram mechanism was converted from linear moving parts to mainly rotating parts.
The new prototype was tested by a panel of experts and novices during an indicative ergonomic experiment. A major advantage of the MIM seems to be the possibility to perform laparoscopic surgery in a sitting position, in line with the working axis, instead of standing at the side of the patient. At an estimated cost level of 10% of the da Vinci system, the MIM can be an economical alternative for the enhancement of laparoscopy ergonomics. However, further development for clinical feasibility is necessary.
自达芬奇机器人系统问世以来，据报道其在人体工程学方面比传统腹腔镜检查（COV）具有优势。该系统的高成本促使我们设计一种更经济的机械替代方案来改善腹腔镜检查的人体工程学：微创操作器（MIM）。
对先前报道的MIM原型进行了研究。其缺点被用作建立新原型设计标准的依据。
开发了一种新原型，旨在提高直观性和人体工程学性能。重新设计了手柄和器械尖端，并将平行四边形机构从线性运动部件转变为主要旋转部件。
在一项指示性人体工程学实验中，新原型由一组专家和新手进行了测试。MIM的一个主要优势似乎是能够以坐姿沿着工作轴进行腹腔镜手术，而不是站在患者一侧。MIM的估计成本仅为达芬奇系统的10%，它可能是增强腹腔镜检查人体工程学的一种经济替代方案。然而，还需要进一步发展以实现临床可行性。
