A novel, intuitive instrument positioner for endoscopy, involving surgeons in design and feasibility.
BACKGROUND
Existing laparoscopic instrument holders do not seem to sufficiently fulfil the needs of surgeons performing minimally invasive surgery (MIS) in several respects. Therefore, we developed and tested a novel laparoscopic instrument positioner in close cooperation between surgeons and engineers.


METHODS
Design requirements were established by attending laparoscopic interventions, interviews and involving surgeons during the design cycle by evaluation of early mock-ups and prototypes.


RESULTS
Two concepts, based on a scissor- and a deflectable ball principle, were elaborated and evaluated yielding a simple, affordable system, fixating all degrees of freedom in the centre of motion. A sterile functional prototype was fabricated and successfully tested during three clinical interventions. Users reported a stable image, easy and intuitive handling and no interference with other surgical instrumentation. The posture was conceived to be more ergonomic and surgeons liked the ability to control the positioning of the endoscope directly themselves.


CONCLUSIONS
Three successful interventions show that involving surgeons in the design and testing phase of product development leads to a novel instrument positioner that can be used safely in a clinical setting. It can be concluded that the system is simple and intuitive to use, as there was no learning curve.
a 1 Department of Medical Technology and Clinical Physics, University Medical Center Utrecht , Utrecht, The Netherlands.
Jesse
J
Bosma
b 2 Department of Urology, University Medical Center Utrecht , Utrecht, The Netherlands.
Arto
A
Boeken Kruger
a 1 Department of Medical Technology and Clinical Physics, University Medical Center Utrecht , Utrecht, The Netherlands.
Joris
J
Jaspers
D000293:Adolescent; D019723:Endoscopes; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006804:Ergonomics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011187:Posture; D066231:Surgeons
Endoscope; assistant; ergonomics; instrument positioner; intuitive