Development of a needle driver with multiple degrees of freedom forneonatal laparoscopic surgery
Development of a needle driver with multiple degrees of freedom forneonatal laparoscopic surgery
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新生儿腹腔镜手术多自由度针驱动器的研制
DOI：
10.1089/lap.2013.0130
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Iwanaka T
中科院分区：
文献类型：
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作者：
Ishimaru T;Takazawa S;Uchida H;Kawashima H;Fujii M;Harada K;Sugita N;Mitsuishi M;Iwanaka T
目的：本研究的目的是开发一种具有多个自由度的细针驱动器，并评估其在多方向穿刺中的疗效，与传统的针drivers.Materials和方法：尖端（15 mm）的新型用户友好的针驱动器（直径3.5 mm）有三个自由度的把握，旋转和偏转。6名小儿外科医生在干燥箱中执行两种缝合任务：垂直或平行于器械插入方向连续缝合3针，首先使用新型器械，然后使用传统器械，最后再次使用新型器械。结果：传统手术和新型手术中，垂直缝合时插入点与目标点的平均间隙分别为0.8 mm和0.7 mm;平行缝合时，插入点与目标点的平均间隙分别为0.8 mm和0.6 mm。常规和新型手术中，垂直方向上从出口点到靶点的平均间隙分别为0.6 mm和0.6 mm;平行方向上分别为0.6 mm和0.8 mm。常规和新型手术的垂直穿刺时间分别为33秒和64秒（P= 0.02）;平行穿刺时间分别为114秒和91秒，分别为：我们的新型针驱动器保持穿刺的准确性;与新型驱动器平行穿刺可能比传统的更容易。
Aims:The aims of this study were to develop a thin needle driver with multiple degrees of freedom and to evaluate its efficacy in multidirectional suturing compared with a conventional needle driver.Materials and Methods:The tip (15 mm) of the novel user-friendly needle driver (3.5 mm in diameter) has three degrees of freedom for grasping, rotation, and deflection. Six pediatric surgeons performed two kinds of suturing tasks in a dry box: three stitches in continuous suturing that were perpendicular or parallel to the insertion direction of the instrument, first using the novel instrument, then using a conventional instrument, and finally using the novel instrument again. The accuracy of insertion and exit compared with the target points and the procedure time were measured.Results:In the conventional and novel procedures the mean gaps from the insertion point to the target in perpendicular suturing were 0.8 mm and 0.7 mm, respectively; in parallel suturing they were 0.8 mm and 0.6 mm, respectively. The mean gaps from the exit point to the target in perpendicular suturing were 0.6 mm and 0.6 mm for conventional and novel procedures, respectively; in parallel suturing they were 0.6 mm and 0.8 mm, respectively. The procedure time for perpendicular suturing was 33 seconds and 64 seconds for conventional and novel procedures, respectively (P=.02); for parallel suturing it was 114 seconds and 91 seconds, respectively.Conclusions:Our novel needle driver maintained accuracy of suturing; parallel suturing with the novel driver may be easier than with the conventional one.