title: Optimizing integration of electrosurgical hand controls within a laparoscopic surgical tool.
abstract: Abstract   In laparoscopic surgery, electrosurgical equipment is operated by means of one or more foot pedals positioned on the floor in front of the surgeon causing poor ergonomic posture and physical discomfort. The focus of this study was to ergonomically explore the integration of electrosurgical hand controls within the previously designed Intuitool™ laparoscopic surgical instrument to optimize functionality. Three different hand control designs (CDs) were implemented within the Intuitool™ and each CD contained the standard cutting and coagulation features, previously operated by foot pedals. This study used 26 right-handed participants, with no previous laparoscopic surgery experience. The participants completed simple tasks using all three CDs within a simulated abdomen. Electromyography (EMG) sensors and force sense resistors (FSRs) were utilized to measure muscle activity and button actuation force, respectively. A questionnaire was also utilized to measure comfort level of each CD. The results indicated that the close proximity of CD 1 generated greater actuation force for all tasks, was rated easier to use (P = 0.003) and was preferred more frequently by the participants (53.8%) compared to CD 2 and 3. As a result, CD 1 was determined to be an optimal ergonomic design for electrosurgical hand controls within the Intuitool™.
authors.affiliation: Innovative Design and Ergonomic Analysis Laboratory, Department of Industrial and Management Systems Engineering, University of Nebraska-Lincoln, Lincoln, NE, USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Rousek
authors.forename: Bernadette
authors.initials: B
authors.lastname: Brown-Clerk
authors.forename: Bethany R
authors.initials: BR
authors.lastname: Lowndes
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Balogh
authors.forename: M Susan
authors.initials: MS
authors.lastname: Hallbeck
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004576:Electromyography / Q000295:instrumentation; D004598:Electrosurgery / Q000295:instrumentation*; D006804:Ergonomics / Q000295:instrumentation; D005260:Female; D006225:Hand; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D011187:Posture; D012984:Software; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D055815:Young Adult