Effectiveness of grasping and duration of clamping using laparoscopic graspers.
BACKGROUND
Manipulating tissue with laparoscopic forceps is more difficult than using the hands. This study investigates the effectiveness of grasping and the duration of tissue-clamping using laparoscopic forceps.


METHODS
Video recordings of 10 laparoscopic colectomies and 15 cholecystectomies were analyzed using time-action analysis.


RESULTS
The results indicated that 62% of the grasping actions were successful: the tissue was clamped sufficiently to perform an action. Of all the clamping actions on the colon, 10% were repeated actions. On the gallbladder 7% were repeated actions. The bowel slipped out of the grasper in 7% of the clamping actions, whereas the gallbladder slipped in 17%. In 89%, the colon was clamped less than 1 min. The maximum clamping time for colon clamps was 7 min for the colon, and 55 min for the gallbladder.


CONCLUSIONS
The low percentage of successful grasping actions indicates that the design of laparoscopic graspers is not optimal.
Heijnsdijk
E A M
EA
Man-Machine Systems Group, Faculty of Design, Engineering, and Production, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands. e.a.m.heijnsdijk@wbmt.tudelft.nl
Dankelman
J
J
Gouma
D J
DJ
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation / Q000592:standards; D003082:Colectomy / Q000009:adverse effects / Q000295:instrumentation / Q000592:standards; D003106:Colon / Q000293:injuries; D004867:Equipment Design / Q000592:standards; D005704:Gallbladder / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D020706:Laparoscopes / Q000592:standards; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D014741:Video Recording