title: Improvement of the laparoscopic needle holder based on new ergonomic guidelines.
abstract: BACKGROUND
  The aim of this study is to create new ergonomic guidelines for the design of laparoscopic needle holders.
  
  
  METHODS
  An ergonomic literature study, observations in the operating room, handle-shaft angle measurements, and anthropometric data were used to compile new ergonomic criteria, specified to the function of a laparoscopic needle holder. Based on these guidelines a new needle holder was designed. The prototype and three currently available needle holders were evaluated according to the new guidelines. In addition, a pelvi-trainer test was done to measure the extreme wrist excursions.
  
  
  RESULTS
  The ergonomic evaluation of three commonly used handles and the new prototype indicate that the new handle is an ergonomic improvement in the field of laparoscopic needle holders: only the new handle satisfies all criteria. This is validated by the results of the pelvi-trainer test, which showed that the new prototype significantly (p <0.001) reduced the extreme wrist excursions.
  
  
  CONCLUSIONS
  The new design guidelines for a laparoscopic needle holder result in an ergonomic improvement of the instrument.
authors.affiliation: Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE Delft, The Netherlands. m.a.vanveelen@io.tudelft.nl
authors.forename: M A
authors.initials: MA
authors.lastname: van Veelen
authors.forename: D W
authors.initials: DW
authors.lastname: Meijer
authors.forename: I
authors.initials: I
authors.lastname: Uijttewaal
authors.forename: R H M
authors.initials: RH
authors.lastname: Goossens
authors.forename: C J
authors.initials: CJ
authors.lastname: Snijders
authors.forename: G
authors.initials: G
authors.lastname: Kazemier
mesh_terms: D004867:Equipment Design / Q000639:trends; D006804:Ergonomics / Q000379:methods*; D017408:Guidelines as Topic; D006801:Humans; D020706:Laparoscopes / Q000639:trends*; D009339:Needles / Q000639:trends*; D013523:Surgical Equipment / Q000639:trends; D013525:Surgical Instruments / Q000639:trends; D013536:Suture Techniques / Q000639:trends; D013647:Task Performance and Analysis