Client: Catharina Hospital, Eindhoven; Eleonora P. Westebring van der Putten
February 2009 - July 2009
Team: Albertien Greijdanus, Phil van den Eerenbeemt, Geert Koemans
Toon Jacobse, Jan Schets, Antonio Récamier
In laparoscopic surgery, a surgeon cannot feel if the tissue manipulated via the graspers is slipping from the tip, or if excessive pressure is exerted. Eleonora Westebring van der Putten, working with the Catharina Hospital, has developed two feedback actuators that warn a surgeon of both situations. Yet, the current solution is not suitable for further testing, as two handles need to function simultaneously in a test setting. To determine whether the system improves the safety of the procedure, two grasper handles were developed, each incorporating two optimized feedback actuators and adhering to proper ergonomic and anthropometric guidelines.
Methods
During the initial research, the latest advances in laparoscopic graspers and feedback actuators were analyzed in order to gain insight into the project and find the best possible solutions for the handle. Aspects regarding ergonomics, electric motors, pulsing and vibrating devices, grasper force feedback, tissue simulators, and wireless connections were explored. The product requirements were generated by combining the client’s needs with general hand tool design guidelines and van Veelen’s action guidelines for laparoscopic instruments. Brainstorming sessions and discussions generated preliminary ideas, in which solutions were proposed for the actuator devices. Finally these partial concepts were later integrated into three global concepts, from which one was developed into the final design.
Results
The new grasper handle with haptic feedback is an ergonomic test device that incorporates two separate feedback actuators, one on each hinge of the product. The front hinge, housing the slippage actuator, opens and closes the grasper shaft enabling tissue manipulation. The back hinge incorporates the force actuators; it also rotates left and right to keep the arm and hand aligned during use. Both of these parts are connected to the main body, which holds the output for all wires from the actuators.
At the end of the project, two identical grasper handles were constructed and presented to the researcher so as to continue testing. The concept was published in by Westebring as part of her PhD research and final dissertation.
Experimental set-up designed by Westebring, in which feedback actuators were attached to the commercial graspers as well as to the user's hand.
Ergonomic analysis of foam models.
Rendering of the laparoscopic grasper.
Final working prototype constructed using different production techniques: Fused Deposited Modelling (rapid prototyping technique) and CNC + manual milling.
Final design of Westebring's training module using our two prototypes. Source: http://www.medgadget.com/2011/01/force_feedback_controller_for_keyhole_surgery.html
