Surgeon-instrument interaction

A hands-off approach

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Abstract

The field of minimally invasive surgery (MIS) is constantly evolving towards the minimization of surgical trauma. Surgical instrumentation enabling this advancement must aid the surgeon, rather than hamper or burden. Surgeon-Instrument Interaction (SII) is of particular importance. Bad SII-design choices during instrument development can complicate procedures, introduce errors, and compromise patient safety. The objective of this thesis is to evaluate and improve SII for MIS instrumentation and to investigate new ways to design for SII, such that potential complications of future instrumentation are avoided.
This thesis is divided into two parts, each relating to an instrument for which the investigation of SII is of significant relevance. Part I discusses the gynaecological morcellator, a dedicated instrument that facilitates the laparoscopic removal of bulk uterine tissue. Contrasting the single-purpose morcellation instrument, Part II discusses multi-functional instrumentation. Specifically, Part II investigates multi-branched instrumentation for natural orifice transluminal endoscopic surgery (NOTES) and presents a new design method towards their future development.