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Related Experiment Videos

Forearm compression by laparoscopic hand-assist devices.

Manoj Monga1, Juan Premoli, Neil Skemp

  • 1Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA. endourol@yahoo.com

Journal of Endourology
|December 16, 2004
PubMed
Summary
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Forearm compression varies significantly among laparoscopic hand-assist devices. The Handport device exerted the least compression, while the LapDisc and Gelport exerted the most, potentially impacting surgeon comfort and performance.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Devices

Background:

  • Laparoscopic hand-assist devices are widely used in urology and other surgical specialties.
  • These devices aid in maintaining pneumoperitoneum during laparoscopic procedures.

Purpose of the Study:

  • To evaluate the forearm compression exerted by commercially available laparoscopic hand-assist devices.
  • To assess the impact of these devices on surgeon comfort and potential nerve impingement.

Main Methods:

  • Five hand-assist devices (Gelport, Intromit, PneumoSleeve, Handport, LapDisc) were tested.
  • Forearm compression forces were measured on three surgeons using a porcine model with FlexiForce sensors.
  • Surgeons also provided subjective ratings on device insertion, hand manipulation, and paresthesias.

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Main Results:

  • The LapDisc showed superior ease of insertion, while the Gelport was rated best for hand insertion/removal.
  • The LapDisc (97 mm Hg) and Gelport (78 mm Hg) generated the highest forearm compression forces.
  • The Handport device resulted in the lowest compression forces (33 mm Hg), with less reported paresthesias.

Conclusions:

  • Device selection should consider ease of use, insufflation efficacy, and impact on surgeon performance and fatigue.
  • The degree of forearm compression and potential for paresthesias are critical factors in choosing hand-assist devices.
  • Further development of new devices should aim to minimize forearm compression and associated risks.