title: Effectiveness of grasping and duration of clamping using laparoscopic graspers.
abstract: 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.
authors: 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
authors: E A M
authors: EA
authors: Heijnsdijk
authors: J
authors: J
authors: Dankelman
authors: D J
authors: DJ
authors: Gouma
mesh_terms: 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