Assessment of joystick and wrist control in hand-held articulated laparoscopic prototypes
Identifieur interne : 002561 ( Main/Exploration ); précédent : 002560; suivant : 002562Assessment of joystick and wrist control in hand-held articulated laparoscopic prototypes
Auteurs : Linde M. Okken [Pays-Bas] ; Magdalena K. Chmarra [Pays-Bas] ; Ellen Hiemstra [Pays-Bas] ; Frank Willem Jansen [Pays-Bas] ; Jenny Dankelman [Pays-Bas]Source :
- Surgical Endoscopy [ 0930-2794 ] ; 2012.
Abstract
Various steerable instruments with flexible distal tip have been developed for laparoscopic surgery. The problem of steering such instruments, however, remains a challenge, because no study investigated which control method is the most suitable. This study was designed to examine whether thumb (joystick) or wrist control method is designated for prototypes of steerable instruments by means of motion analysis.
Five experts and 12 novices participated. Each participant performed a needle-driving task in three directions (right → left, up → down, and down → up) with two prototypes (wrist and thumb) and a conventional instrument. Novices performed the tasks in three sessions, whereas experts performed one session only. The order of performing the tasks was determined by Latin squares design. Assessment of performance was done by means of five motion analysis parameters, a newly developed matrix for assigning penalty points, and a questionnaire.
The thumb-controlled prototype outperformed the wrist-controlled prototype. Comparison of the results obtained in each task showed that regarding penalty points, the up → down task was the most difficult to perform.
The thumb control is more suitable for steerable instruments than the wrist control. To avoid uncontrolled movements and difficulties with applying forces to the tissue while keeping the tip of the instrument at the constant angle, adding a “locking” feature is necessary. It is advisable not to perform the needle driving task in the up → down direction.
Url:
DOI: 10.1007/s00464-011-2138-7
PubMed: 22234593
PubMed Central: 3372775
Affiliations:
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Okken</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, Leiden University Medical Center, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Chmarra, Magdalena K" sort="Chmarra, Magdalena K" uniqKey="Chmarra M" first="Magdalena K." last="Chmarra">Magdalena K. Chmarra</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="Hiemstra, Ellen" sort="Hiemstra, Ellen" uniqKey="Hiemstra E" first="Ellen" last="Hiemstra">Ellen Hiemstra</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, Leiden University Medical Center, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Jansen, Frank Willem" sort="Jansen, Frank Willem" uniqKey="Jansen F" first="Frank Willem" last="Jansen">Frank Willem Jansen</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, Leiden University Medical Center, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="Dankelman, Jenny" sort="Dankelman, Jenny" uniqKey="Dankelman J" first="Jenny" last="Dankelman">Jenny Dankelman</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author></analytic><series><title level="j">Surgical Endoscopy</title><idno type="ISSN">0930-2794</idno><idno type="eISSN">1432-2218</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Various steerable instruments with flexible distal tip have been developed for laparoscopic surgery. The problem of steering such instruments, however, remains a challenge, because no study investigated which control method is the most suitable. This study was designed to examine whether thumb (joystick) or wrist control method is designated for prototypes of steerable instruments by means of motion analysis.</p></sec><sec><title>Methods</title><p>Five experts and 12 novices participated. Each participant performed a needle-driving task in three directions (right → left, up → down, and down → up) with two prototypes (wrist and thumb) and a conventional instrument. Novices performed the tasks in three sessions, whereas experts performed one session only. The order of performing the tasks was determined by Latin squares design. Assessment of performance was done by means of five motion analysis parameters, a newly developed matrix for assigning penalty points, and a questionnaire.</p></sec><sec><title>Results</title><p>The thumb-controlled prototype outperformed the wrist-controlled prototype. Comparison of the results obtained in each task showed that regarding penalty points, the up → down task was the most difficult to perform.</p></sec><sec><title>Conclusions</title><p>The thumb control is more suitable for steerable instruments than the wrist control. To avoid uncontrolled movements and difficulties with applying forces to the tissue while keeping the tip of the instrument at the constant angle, adding a “locking” feature is necessary. It is advisable not to perform the needle driving task in the up → down direction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dankelman, J" uniqKey="Dankelman J">J Dankelman</name></author><author><name sortKey="Grimbergen, Ca" uniqKey="Grimbergen C">CA Grimbergen</name></author><author><name sortKey="Stassen, Hg" uniqKey="Stassen H">HG Stassen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Frede, T" uniqKey="Frede T">T Frede</name></author><author><name sortKey="Stock, C" uniqKey="Stock C">C Stock</name></author><author><name sortKey="Rassweiler, Md" uniqKey="Rassweiler M">MD Rassweiler</name></author><author><name sortKey="Alken, P" uniqKey="Alken P">P Alken</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Emam, Ta" uniqKey="Emam T">TA Emam</name></author><author><name sortKey="Hanna, G" uniqKey="Hanna G">G 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name="Hollande-Méridionale"><name sortKey="Okken, Linde M" sort="Okken, Linde M" uniqKey="Okken L" first="Linde M." last="Okken">Linde M. Okken</name></region><name sortKey="Chmarra, Magdalena K" sort="Chmarra, Magdalena K" uniqKey="Chmarra M" first="Magdalena K." last="Chmarra">Magdalena K. Chmarra</name><name sortKey="Dankelman, Jenny" sort="Dankelman, Jenny" uniqKey="Dankelman J" first="Jenny" last="Dankelman">Jenny Dankelman</name><name sortKey="Hiemstra, Ellen" sort="Hiemstra, Ellen" uniqKey="Hiemstra E" first="Ellen" last="Hiemstra">Ellen Hiemstra</name><name sortKey="Jansen, Frank Willem" sort="Jansen, Frank Willem" uniqKey="Jansen F" first="Frank Willem" last="Jansen">Frank Willem Jansen</name><name sortKey="Jansen, Frank Willem" sort="Jansen, Frank Willem" uniqKey="Jansen F" first="Frank Willem" last="Jansen">Frank Willem Jansen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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