New Ergonomic Design Criteria for Handles of Laparoscopic Dissection Forceps

Abstract

Background: The shape of laparoscopic instrument handles can cause physical discomfort. This problem may be ascribed to a lack of standards for instrument design. In this study, new ergonomic requirements for the design of laparoscopic dissection forceps were created. Three representative handles (a Karl Storz [click-line] scissors handle, an Access Plus scissors handle, and an Aesculap cylindrical handle) currently available on the market were evaluated according to the new list of ergonomic criteria. Materials and Methods: The handles were subjectively (questionnaire) and objectively (video analyses) tested in order to find out whether the new requirements are valid for the evaluation and design of instrument handles. Results: The outcome of the subjective and objective tests matched the predictions by the new criteria list. New criteria were introduced (neutral wrist excursions), and existing general criteria were specified (e.g., a minimal contact area of 10 mm). Significant differences were found among the three handles. The Storz handle met 8 of the 10 requirements, the Access handle met 5, and the Aesculap handle met only 4. Conclusions: The new list of ergonomic requirements is a valid tool to determine the ergonomic value of a handle for laparoscopic dissecting tasks. It gains its strength from its specialized character. Significant differences were found among the three tested handles. Cylindrical handles were inferior to scissors handles.