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, 13 (4), 379-384

Ergonomics of Laparoscopic Graspers and the Importance of Haptic Feedback: The Surgeons' Perspective


Ergonomics of Laparoscopic Graspers and the Importance of Haptic Feedback: The Surgeons' Perspective

Chantal C J Alleblas et al. Gynecol Surg.


Haptic feedback is drastically reduced in laparoscopic surgery compared to open surgery. Introducing enhanced haptic feedback in laparoscopic instruments might well improve surgical safety and efficiency. In the design process of a laparoscopic grasper with enhanced haptic feedback, handle design should be addressed to strive for optimal usability and comfort. Additionally, the surgeons' perspective on the potential benefits of haptic feedback should be assessed to ascertain the clinical interest of enhanced haptic feedback. A questionnaire was designed to determine surgeons' use and preferences for laparoscopic instruments and expectations about enhanced haptic feedback. Surgeons were also asked whether they experience physical complaints related to laparoscopic instruments. The questionnaire was distributed to a group of laparoscopic surgeons based in Europe. From the 279 contacted subjects, 98 completed the questionnaire (response rate 35 %). Of all respondents, 77 % reported physical complaints directly attributable to the use of laparoscopic instruments. No evident similarity in the main preference for graspers was found, either with or without haptic feedback. According to respondents, the added value of haptic feedback could be of particular use in feeling differences in tissue consistencies, feeling the applied pressure, locating a tumor or enlarged lymph node, feeling arterial pulse, and limiting strain in the surgeon's hand. This study stresses that the high prevalence of physical complaints directly related to laparoscopic instruments among laparoscopic surgeons is still relevant. Furthermore, the potential benefits of enhanced haptic feedback in laparoscopic surgery are recognized by laparoscopic specialists. Therefore, haptic feedback is considered an unmet need in laparoscopy.

Keywords: Ergonomics; Haptic feedback; Human-product interaction; Laparoscopy.

Conflict of interest statement

Compliance with ethical standards Funding This study was funded with a grant provided by the European Regional Development Fund. Conflict of interest CCJ Alleblas and TE Nieboer have no conflicts of interest to disclose. MPH Vleugels is an inventor of haptic feedback instruments. Ethical approval This is not applicable for this study. Informed consent The subjects were informed about the aim of this study. By completing the questionnaire, the participants implicitly declared their agreement with the use of their data for this study.


Fig. 1
Fig. 1
Prevalence of physical complaints in the upper extremities (directly attributable to the use of laparoscopic instruments)
Fig. 2
Fig. 2
Hand map [26] including the frequency of reported areas of discomfort due to pressure caused by instruments
Fig. 3
Fig. 3
Presented handles for assessment including use and preferences for current use and future haptic feedback instruments. HF haptic feedback
Fig. 4
Fig. 4
Illustration of the palm grip (left) versus the usual grip (right)

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    1. Breedveld P, Stassen HG, Meijer DW, Jakimowicz JJ. Manipulation in laparoscopic surgery: overview of impeding effects and supporting aids. J Laparoendosc Adv Surg Tech A. 1999;9:469–480. doi: 10.1089/lap.1999.9.469. - DOI - PubMed
    1. Westebring-van der Putten EP, Goossens RHM, Jakimowicz JJ, Dankelman J. Haptics in minimally invasive surgery—a review. Minim Invasive Ther Allied Technol. 2008;17:3–16. doi: 10.1080/13645700701820242. - DOI - PubMed
    1. Ottermo MV, Ovstedal M, Lango T, Stavdahl O, Yavuz Y, Johansen TA, Marvik R. The role of tactile feedback in laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2006;16:390–400. doi: 10.1097/01.sle.0000213734.87956.24. - DOI - PubMed
    1. den Boer KT, Herder JL, Sjoerdsma W, Meijer DW, Gouma DJ, Stassen HG. Sensitivity of laparoscopic dissectors—what can you feel? Surg Endosc. 1999;13:869–873. doi: 10.1007/s004649901122. - DOI - PubMed
    1. Bholat OS, Haluck RS, Kutz RH, Gorman PJ, Krummel TM. Defining the role of haptic feedback in minimally invasive surgery. Stud Health Technol Inform. 1999;62:62–66. - PubMed

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