Forces in Laparoscopic Surgical Tools

Minimally invasive surgery (MIS), even with its shortcomings, has had a far reaching impact in the field of surgery. During MIS procedures, as the surgeon's hands are remote from the site of the surgery, they do not have a feel of the tissue being manipulated and the forces that should be applied to manipulate the tissue. Studies are being conducted to provide tactile and force feedback of the tissues being manipulated to the surgeon. However, the surgeons are trained in conventional surgery and are familiar with the forces that they apply on the conventional surgical tools. Therefore, before such studies are conducted, there is a need for quantitative comparison of conventional and laparoscopic tools. The purpose of the present investigation was to determine if the forces applied on the conventional surgical forceps are the same as those applied on the laparoscopic forceps during the same procedures. The results of the study showed that the handle and tip forces in laparoscopic forceps were significantly different from that of the conventional surgical forceps (p ≤0.005). The results also showed that the mean power of the surface EMG measured from flexor pollicis brevis (flexor of the thumb) and the extensor pollicis brevis (extensor of the proximal thumb) while manipulating laparoscopic forceps were significantly different from that measured while manipulating conventional surgical forceps for the same procedure (p ≤ 0.005).