Department of Biomechanical EngineeringDelft University of Technology 2628 CD Delft The Netherlands.
Spijkenisse Medisch Centrum 3201 GZ Spijkenisse The Netherlands.
IEEE J Transl Eng Health Med. 2023 Jul 3;11:451-459. doi: 10.1109/JTEHM.2023.3291925. eCollection 2023.
In laparoscopic surgery, quality of haptic feedback is reduced compared to conventional surgery, leading to unintentional tissue damage during grasping. From the perspective of haptics, poor mechanical design of laparoscopic instrument joints induces friction and a nonlinear actuation-tip force relation. In this study, a novel laparoscopic grasper using compliant joints and a magnetic balancer is presented, and the reduction in hysteresis and friction is evaluated. The hysteresis loop of the novel compliant grasper and two conventional laparoscopic graspers (high quality leading commercial brand and low quality unbranded grasper) were measured. In order to assess quality of haptic feedback, the lowest grasper tip load perceivable by instrument users was measured with the novel and the conventional laparoscopic graspers. The hysteresis loop measurement yielded a mechanical efficiency of 43% for the novel grasper, compared to- 25% and 23% for the Aesculap and the unbranded grasper, respectively. The forces perceivable by the user through the novel grasper were significantly lower (mean 1.37N, SD 0.44N) than those of conventional graspers (mean 2.15N, SD 0.71N and mean 2.65N, SD 1.20N, respectively). The balanced compliant grasper technology has the ability to improve the quality of haptic feedback compared to conventional laparoscopic graspers. Research is needed to relate these results to soft and delicate tissue grasping in a clinical setting, for which this instrument is intended.
在腹腔镜手术中，与传统手术相比，触觉反馈的质量降低了，导致在抓取过程中无意中损伤组织。从触觉的角度来看，腹腔镜器械关节的机械设计不佳会导致摩擦和非线性的执行器-尖端力关系。在这项研究中，提出了一种使用柔顺关节和磁平衡器的新型腹腔镜抓握器，并评估了滞后和摩擦的减少。测量了新型柔顺抓握器和两种传统腹腔镜抓握器（高质量领先商业品牌和低质量无品牌抓握器）的滞后环。为了评估触觉反馈的质量，使用新型和传统腹腔镜抓握器测量了仪器使用者可感知的最低抓握器尖端负载。滞后环测量结果表明，新型抓握器的机械效率为 43%，而 Aesculap 和无品牌抓握器的机械效率分别为 25%和 23%。通过新型抓握器感知到的力明显低于传统抓握器（平均值 1.37N，标准差 0.44N）（平均值 2.15N，标准差 0.71N 和平均值 2.65N，标准差 1.20N，分别）。平衡柔顺抓握器技术有能力提高触觉反馈的质量，与传统腹腔镜抓握器相比。需要进行研究将这些结果与旨在用于软性和精细组织抓取的临床环境联系起来。
