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Force-adjustable parallel-occlusion grasper.

Hamza Khan1, Stuart Coleman, Alfred Cuschieri

  • 1School of Medicine, University of Dundee, United Kingdom.

International Journal of Surgery (London, England)
|November 23, 2023
PubMed
Summary
This summary is machine-generated.

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Surgeons can now use novel force-adjustable graspers to precisely control grip strength during laparoscopic surgery, reducing tissue damage. These smart graspers offer selectable force levels for delicate gastrointestinal tract procedures.

Area of Science:

  • Surgical Instrumentation
  • Biomedical Engineering
  • Minimally Invasive Surgery

Background:

  • Laparoscopic surgery uses long graspers that risk iatrogenic damage to delicate gastrointestinal tract (GIT) tissues.
  • Diseases like peritonitis and inflammatory bowel disease increase this risk.
  • Existing parallel-closing instruments offer limited protection against tissue crushing.

Purpose of the Study:

  • To design and test a novel smart grasper that minimizes grasping force for inflamed tissues and hollow viscera.
  • To develop an instrument capable of exerting a preselected, uniform grasping force on the GIT.

Main Methods:

  • A force-adjustable parallel-occlusion grasper (FA-POG) was designed and developed in an ISO 13485-certified facility.
  • A compression spring mechanism in the handle allows for controlled, graded reduction of grasping force.

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  • The FA-POG incorporates a force-level controller knob for surgeon-selected grip force.

    • Main Results:

    • The FA-POG exerts a uniform force (1-5 N) on grasped tissue, adjustable by the surgeon based on pathological conditions.
    • In vitro tests using porcine small-bowel segments validated the prototype's performance.
    • The design features end-effector jaws with a 4-bar linkage for uniform parallel-occlusion force.

    Conclusions:

    • The developed parallel-occlusion grasper allows surgeons to preselect grasping force, preventing excessive pressure.
    • The FA-POG design surpasses traditional scissor-type graspers in uniform force application.
    • Experimental validation confirmed the design's efficacy, with optimized teeth for grip friction.