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Abstract

The authors provide an overview of laparoscopic dissecting instruments and discuss early development, surgical options, and special features. End effectors of different shapes and functions are described. A comparison of available energy sources for laparoscopic instruments includes discussion of thermal dissection, ultrasonic dissection, and water-jet dissection. The ergonomic risks and challenges inherent in the use of current laparoscopic instruments are outlined, as well as ergonomic issues for the design of future instruments. New directions that laparoscopic instrumentation may take are considered in connection with developing technology in robotics, haptic feedback, and MicroElectroMechanical Systems. Copyright © 2001 by W.B. Saunders Company.

Keywords

Laparoscopic instruments ultrasonic dissection ergonomic laparoscopic instruments electrosurgery water-jet surgery laser surgery haptic feedback robotics.

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References

Litynski GS : Hans Frangenheim and Cold light, in Litynski GS : Highlights in the History of Laparoscopy. Frankfurt/Main, Germany, Barbara Bernert Verlog, 1996, pp 91-98

Litynski GS : The controversy surrounding Semm's insufflattor, in Litynski GS : Highlights in the History of Laparoscopy. Frankfurt/Main, Germany, Barbara Bernert Verlog, 1996, pp 99-114

Chang W. : How the medical video camera became the surgeon's tool, in Arregui ME , Fitzgibbons RJ , Kathkhouda N , et al (eds): Principles of Laparoscopic Surgery. Basic and Advanced Techniques . New York, NY, Springer-Verlag , 1995 , pp 775-786

Melzer A. : Endoscopic instruments-conventional and intelligent, in Toouli J , Gossot D , Hunter J (eds): Endosurgery. New York, NY, Churchill Livingston, 1996, pp 69-95

Fengler T. , Pahlke H. , Kraas E. : Sterile and economic instrumentation in laparoscopic surgery: Experiences with 6,000 surgical laparoscopies, 1990-1996. Surg Endosc 12:1275-1279, 1998

den Boer K. , Herder J. , Sjoerdsma W. , et al: Sensitivity of laparoscopic dissectors: What can you feel? Surg Endosc 13:869-873, 1999

Van Veelen M. , Meijer D. : Ergonomics and design of laparoscopic instruments: Results of a survey among laparoscopic surgeons. J Laparoendosc Adv Surg Tech A 9:481-489, 1999

Muller W. , Fritzach G. : Medico-technical basics of surgery using invasive ultrasonic energy . Surg Endosc 2:205-210, 1994

Lantis JC , Durville FM , Connolly R. , et al: Comparison of coagulation modalities in surgery. J Lap Adv Surg Tech 8:381-393, 1998

10.

Shimi SM : Dissection techniques in laparoscopic surgery: A review. J Royal Coll Surg Edin 40:249-259, 1.995

11.

Nduka CC , Super PA , Monson Jrt , et al: Cause and prevention of electrosurgical injuries in laparoscopy . J Am Coll Surg 179:161-170, 1994

12.

Reich H. : Laparoscopic bowel injury. Surg Laparosc Endosc 2:74-78, 1992

13.

Hodgson WJ , Morgan J. , Byrne D. , et al: Hepatic resections for primary and metastatic tumors using the ultrasonic surgical dissector. Am J Surg 163:246-250, 1992

14.

Cuschieri A. , Shimi S. , Banting S. , et al: Endoscopic ultrasonic dissection for thoracoscopic and laparoscopic surgery. Surg Endosc 7:197-199, 1993

15.

Mueller W. , Frizsch G. : Medicotechnical basics of surgery using invasive ultrasonic energy . Endosc Surg Allied Technol 2:205-210, 1994

16.

Birch DW , Park A. , Shuhaibar H. : Acute thermal injury to the canine jejunal free flap: Electrocautery versus ultrasonic dissection. Am Surg 65:334-337, 1999

17.

Swanstrom LL , Pennings JL : Laparoscopic control of short gastric vessels . J Am Coll Surg 181:347-351, 1995

18.

Laycock WS , Trus TL , Hunter JG : New technology for the division of short gastric vessels during laparoscopic Nissen fundoplication: A prospective randomized trial. Surg Endosc 10:77-73, 1996

19.

Laycock WS , Trus TL , Hunter JG : New technology for the division of short gastric vessels during laparoscopic Nissen fundoplication: A prospective randomized trial. Surg Endosc 10:77-73, 1996

20.

Papachristou DN , Barters R. : Resection of the liver with a water-jet. Br J Surg 69:93-94, 1982

21.

Schob OM , Schlumpf RB , Uhlschmidt GK , et al: The multimodal waterjet dissector: A technology for laparoscopic liver surgery. Endosc Surg 2:311-314, 1994

22.

Lantis JC , Durville FM , Connolly R. , et al: Comparison of coagulation modalities in surgery. J Lap Adv Surg Tech 8:381-393, 1998

23.

Bordelon B. , Hunter JG : Laser versus electrosurgery in laparoscopic cholecystectomy. A prospective randomized trial. Arch Surg 128:233-236, 1993

24.

Kennedy JS , Stranahan PL , Taylor KD , et al: High-burst-strength, feedback-controlled bipolar vessel sealing . Surg Endosc 12:876-878, 1998

25.

Heniford BT , Sing R. , Matthews B. , et al: Initial results with an electrothermal bipolar vessel sealer. Surg Endosc (in press)

26.

Hanna GB , Frank TG , Cuschieri A. : Objective assessment of endoscopic knot quality. Am J Surg 174:410-413, 1998

27.

Berguer R. : Surgical technology and the ergonomics of laparoscopic instruments . Surg Endosc 12:458-462, 1998

28.

Rosen J. , MacFarlane M. , Richards C. , et al: Surgeon-tool force/torque signatures: Evaluation of surgical skills in minimally invasive surgery. Proceedings of Medicine Meets Virtual Reality, San Francisco, CA, IOS Press, 1999, pp 1-10

29.

Berguer R. : Ergonomics in the operating room. Am J Surg 171:385-386, 1996

30.

Cuschieri A. : Whither minimal access surgery: Tribulations and expectations. Am J Surg 169:9-19, 1995

31.

Smith WD , Forkey DL , Berguer R. : The virtual instrumentation (VI) laboratory facilitates customized on-site ergonomic analysis of minimally invasive surgery. Proceedings of Medicine Meets Virtual Reality: Art, Science, Technology: Healthcare (R)evolution San Francisco, CA, IOS Press, 1998, pp 240-245

32.

Taylor RH , Funda J. , Eldridge B. , et al: A telerobotic assistance for laparoscopic surgery. IEEE Eng Med Biol 14:279-288, 1995

33.

Schurr MO , Buess G. , Neisius B. , et al: Robotics and allied technologies in endoscopic surgery. Surg Technol Int 7:83-88, 1995

34.

Zucker KA : Laparoscopy and robotic surgery, in Zucker KA (ed): Surgical Laparoscopy. Philadelphia, PA, Lippincott Williams & Wilkins, 2000, pp 803-808

35.

Salisbury P. , Kenneth J. : Proceedings of the second PHANToM user's group workshop, 19-22 Oct 1997, AI Lab Technical Report 1617. Dedham, MA, Endicott House, pp 34-37

Laparoscopic Dissecting Instruments

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