An articulated handle to improve the ergonomic performance of robotic dextrous instruments for laparoscopic surgery

Abstract. Hand-held robotic instruments with dextrous end-effectors offer increased accessibility and gesture precision in minimally invasive laparoscopic surgery. They combine advantages of both intuitive but large, complex, and expensive telesurgery systems, and much cheaper but less user-friendly steerable mechanical instruments. However, the ergonomics of such instruments still needs to be improved in order to decrease surgeon discomfort. Based on the results of former experimental studies, a handle connected to the instrument shaft through a lockable ball joint was designed. An experimental assessment of ergonomic and gesture performance was performed on a custom-made virtual reality simulator. Results show that this solution improves ergonomics, demanding less wrist flexion and deviation and elbow elevation, while providing gesture performance similar to a robotic dextrous instrument with standard pistol-like handle configuration.