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A new multitool for hand-assisted advanced laparoscopic surgery (HALS).

A Cuschieri1, T G Frank, S Brown

  • 1Department of Surgery and Molecular Oncology, Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, Scotland, UK. a.cuschieri@dundee.ac.uk

Surgical Endoscopy
|June 24, 2003
PubMed
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A new multitool for hand-assisted laparoscopic surgery (HALS) improves suturing efficiency by 30%. This reusable instrument, worn on the little finger, provides easy access to dissecting forceps, a needle driver, and scissors during complex procedures.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Instrumentation
  • Laparoscopic Technology

Background:

  • Hand-assisted laparoscopic surgery (HALS) enables complex procedures with enhanced tactile feedback.
  • Development of specialized instruments is crucial for optimizing HALS.
  • Previous evaluations focused on various internal assisting hand tools.

Purpose of the Study:

  • To develop and evaluate a novel, reusable multitool for the internal assisting hand in HALS.
  • To assess the functionality and efficiency of the multitool in laboratory and clinical settings.

Main Methods:

  • Design and fabrication of the Dundee Multitool (DMT), featuring thumb-actuated forceps, needle driver, and scissors.
  • Laboratory testing using HALS trainers.
  • Clinical evaluation in major HALS operations following institutional and patient consent.

Related Experiment Videos

Main Results:

  • The DMT demonstrated ease of deployment and effective function of all integrated instruments.
  • Intracorporeal suturing and tissue manipulation were performed efficiently.
  • Suturing time was reduced by 30% compared to total laparoscopic suturing when using the DMT needle driver in conjunction with external hand manipulation.

Conclusions:

  • A novel, little-finger-hung multitool for HALS surgery has been successfully developed and evaluated.
  • The Dundee Multitool (DMT) integrates essential surgical instruments for enhanced procedural efficiency.
  • Both laboratory and clinical results confirm the multitool's good functionality and significant improvement in suturing efficiency.