Instrument trains surgeons to perform keyhole surgery

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Delft University of Technology researcher Eleonora Westebring-van der Putten has developed a device aimed at training surgeons to perform keyhole surgery.

An exploratory operation – known as a laparoscopy when carried out in the abdominal cavity – is generally less invasive for the patient.

However, problems with keyhole surgery partly arise because it is very difficult to gauge the force of the surgeon’s grasp. The surgeon is therefore less able to determine whether he or she is grasping the tissue too hard or too gently.

Westebring has developed a working prototype of a laparoscopic grasp instrument that gives augmented feedback on the amount of grasp force being applied.

‘There are sensors in the tip of the instrument that measure how hard the surgeon is grasping,’ said Westebring. ‘This information is fed back to the handle, which contains a cylinder that can turn in relation to the hand, as if something is falling out of your hand. In this way, the cylinder indicates that the surgeon has too little grip, and is therefore grasping too gently.

‘The handle also contains vibrating elements, which start to vibrate if the surgeon is grasping too hard, while also taking account of how hard the surgeon is pulling. The harder he or she pulls on the tissue, the less hard he or she should grasp.’

In the future an instrument such as Westebring’s could be used in training for real operations.

‘By training with feedback, surgeons learn to control their laparoscopic grasp force more quickly. The forces they apply are lower.’

Westebring added that when the feedback signal is removed, the surgeons can still carry out the procedure with reduced force.