Laparoscopic scissors: a subjective and objective comparison of three brands

Area of Science:

• Surgical Instrumentation
• Minimally Invasive Surgery
• Biomaterials Science

Background:

• Laparoscopic surgery frequently utilizes scissors for diverse tissue types, including challenging fibrotic or calcified tissues, sutures, and stapled materials.
• Disposable laparoscopic scissors can lose efficacy over time, necessitating evaluation of instrument durability.

Purpose of the Study:

• To comparatively assess the durability and ergonomic properties of three distinct brands of laparoscopic scissors.
• To identify the most robust and user-friendly laparoscopic scissor for surgical applications.

Main Methods:

• Three laparoscopic scissor brands (Applied Medical Direct Drive, Ethicon Endosurgery Endopath, U.S. Surgical Auto Suture Endo Shear) underwent objective and subjective evaluations.
• Objective analysis involved high-resolution digital photography and scanning electron microscopy to quantify blade imperfections post-use.
• Subjective assessments included ratings from experienced surgeons and blinded volunteers on cutting performance and ergonomics.

Main Results:

• All tested scissors effectively cut fresh tissue; however, the Direct Drive exhibited superior performance in cutting staples and subsequent tissue.
• Volunteers preferred the Direct Drive for its cutting ability and ergonomics, supported by objective data showing less blade damage.
• The Direct Drive's reusable handle offered significant cost savings (53-59%) over the disposable alternatives.

Conclusions:

• The Direct Drive laparoscopic scissors offer superior durability and ergonomics compared to the Endopath and Endo Shear models.
• This brand provides a cost-effective solution without compromising surgical performance, particularly in demanding cutting tasks.