Grip in laparoscopic surgery by means of adhesion: A background information report

Grip in laparoscopic surgery by means of adhesion: A background information report

Verhoef, J.

Breedveld, P. (mentor)

Mechanical, Maritime and Materials Engineering

Biomechanical Engineering

2005-12-01

Minimally invasive surgery (MIS) is a surgery technique that is carried out through small incisions in the skin with thin, long instruments. In order for the surgeon to see his actions with his instruments, a small camera with a light source (an endoscope) is used to look inside the person that is operated. MIS, also called laparoscopy when carried out in the abdominal cavity, has many advantages compared to traditional surgery such as less operative trauma and reduced hospitalization time. However, there are many disadvantages as well. Especially for the surgeon a lot of aspects of surgery have become more difficult. The instruments that the surgeon uses are small and have tiny forceps in order to fit through the incisions. A problem that occurs with these forceps is that of not having good grip on the slippery tissue. The surgeon tries to prevent this by using a large pinch force and using forceps that are provided with a saw-tooth profile. The consequence however is that due to these two solutions the tissue sometimes gets damaged. Since a lot of research is done nowadays on adhesives that stick to mucus tissue (mucoadhesives), it is interesting to investigate whether it is worthwhile to design and develop a laparoscopic forceps that provides the grip with the tissue by means of such a mucoadhesive so that large pinch forces and profiles are not necessary anymore. This thesis gives background information on this subject by studying chemistry, physics, patent and biological literature. From physical and chemistry information, insight was gained on the working principles of adhesion in general. For using a mucoadhesive on a laparoscopic forceps in order to manipulate the tissue, the adhesion mechanism between forceps and tissue must be temporary. This adhesion mechanism must be strong enough but must have a quick release or deactivation mechanism as well. From a patent research came forward that there is very little done on the area of manipulating tissue by means of an adhesive. The main problem of using an adhesive to create grip with tissue is how to loosen the adhesive again from the tissue. No patent was found that explained a method of loosening the adhesive again, which confirmed that this is the most important problem that has to be solved to come to a good design. In order to investigate methods for undoing adhesion, research in biological literature was done, because temporary adhesion is something that is used by a lot of animals for instance to walk upside down a ceiling. From a number of examples of temporary adhesion mechanisms a number of release mechanisms were found. From the demands that the release mechanism should suffice to be used on a laparoscopic forceps, two interesting release mechanisms came forward. These release mechanisms, peeling and hydration of the mucoadhesive need further investigation. Overall can be concluded that from the background information presented in this thesis it can be recommended to do further research for the design of a laparoscopic forceps that has grip by means of a mucoadhesive. Peeling of the mucoadhesive or hydrating are the most interesting release mechanisms that could be applied in such a forceps.

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Student theses

master thesis

(c) 2005 Verhoef, J.