Print Email Facebook Twitter The feasibility of vacuum technique in minimal invasive surgery: Improving the patient safety through instrument design Title The feasibility of vacuum technique in minimal invasive surgery: Improving the patient safety through instrument design Author Vonck, D. Contributor Goossens, R.H.M. (promotor) Jakimowizc, J.J. (promotor) Faculty Industrial Design Engineering Department Industrial Design Date 2013-04-24 Abstract Grasping in minimal invasive surgery (MIS) is conducted with so called laparoscopic graspers. These graspers are generally derivatives of instruments used in open surgery. The performance of these graspers depends on the technical and medical functionality, the skills and experience of the user, the surgeon, and the comfort of use related to the instrument. The foremost characteristic required for any grasp instrument in grasping soft organs and tissue is the so called ‘safe grip’. The technical and medical functionality of any grasp instrument depends on this property. The patient safety was defined as the completion of a procedure throughout which no adverse events take place which compromise the physical (and also mental) wellbeing of a patient. Vacuum technique as grasping technique for MIS was chosen as research subject for this thesis. There were three main reasons for this choice. First, vacuum technique is a widely applied grasp technique in industry. Besides the potential induced by its variety of applications in industry, vacuum technique, as grasp technique for MIS, has been studied concerning its potential. These studies underline the potential of vacuum technique however, the findings were not translated to actual applications in MIS nor was any knowledge provided concerning the conditions or requirements in relation to vacuum grasping which ensure a safe grip. The third aspect of vacuum technique is its physical principles. Vacuum grasping is a very controlled and homogenous way of grasping. The ‘object’ type which was grasped by means of vacuum was the bowel. The bowel is an organ which is frequently grasped during MIS procedures. It is a very delicate and easily damaged. Bowel damage can have serious consequences for the patient. With regard to grasping the bowel no research has yet been conducted concerning vacuum grasping. Design Inclusive Research (DIR) was applied as the methodological tool concerning this project. DIR is characterized by the incorporation of design activities which support and provide as input for the research activities. This particular method was chosen due to the intention and necessity of developing vacuum grasp instruments on behalf of the research activities. As stated above, this thesis focusses on the feasibility of vacuum technique as grasp technique for MIS. This is based on the premise that we strive to a constant performance regardless of the skills and experience of the user. The research question was defined as, is vacuum technique feasible as grasping technique for minimal invasive surgery? This feasibility can be interpreted as the feasibility of a vacuum grasp instrument. The performance is determined by the technical aspects, the skills and experience of the surgeon and the comfort of use. This leads to three focus areas. The first two focus points are related to the technical and medical functionality (grip and damage). The third focus point is derived the comfort of use. From this study it can be conclude that, vacuum technique as grasp technique has potential to be used in minimal invasive surgery, no damage to the bowel was encountered either at the macroscopic or at the microscopic level. A try-out towards grasping other types of tissue showed that vacuum also has potential to safely grasp the liver, gallbladder and spleen. From a technical view point vacuum technique offers a number of benefits concerning the physical principle of vacuum grasping. It is a very constant and controllable way of grasping which provides sufficient grip on the bowel. Vacuum technique does not compress the tissue and seems none sensitive to variations in the tissue such as differences in wall thickness and tissue folds which adds to the safe way of grasping. The nozzles of the instruments have no moving parts and the vacuum is limited. Therefore it makes no difference whether the instruments are used by an expert or a novice. The performance on this aspect is constant regardless of the skills and experience of the user. The overall conclusion is that basically vacuum technique is a safe and useful technique to grasp the bowel. Subject safe vacuum grasping To reference this document use: https://doi.org/10.4233/uuid:ebc846a3-e98e-4ae3-9863-6cc3a839d2b5 Embargo date 2013-04-16 ISBN 9789461861481 Part of collection Institutional Repository Document type doctoral thesis Rights (c) 2013 Vonck, D. Files PDF Thesis_final_Durandus_.pdf 5.26 MB PDF propositions_thesis_Duran ... _Vonck.pdf 11.07 KB Close viewer /islandora/object/uuid:ebc846a3-e98e-4ae3-9863-6cc3a839d2b5/datastream/OBJ1/view