• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Comparing the Biomechanical Characteristics of Manual and Powered Laparoscopic Stapler Designs

Donald R Peterson, PhD, Drew R Seils, BS, Tarek Tantawy, BS, Angela S Kueck, MD, M Kurt E Roberts, MD. University of Connecticut Health Center, Yale University

 

INTRODUCTION: The incidence of musculoskeletal disorders among laparoscopic surgeons is increasing and may be a result of an increase in surgical procedures performed and the biomechanical risks associated with manually-operated laparoscopic instrument use. The introduction of battery-powered surgical instruments may alleviate some of the biomechanical stressors experienced with their manual counterparts and provide an increase in surgical accuracy and efficiency. To better understand and compare the biomechanical risks associated with the use of manual and powered laparoscopic surgical staplers, the physical characteristics and the forces required to activate the various functions of a stapler, including staple firing and blade retraction, were measured for two manual designs (Covidien Endo GIA Ultra, Ethicon Echelon Flex 60) and one powered design (Covidien iDrive Ultra). Measurements included the identification of key ergonomic features such as handle shape and contour, handle angle, hand and finger reach, and grip spans.

METHODS AND PROCEDURES: All physical dimensions were measured using precision calipers and an image analysis software protocol, configured for linear and angular metrics, was used to characterize high-resolution photographs taken of each stapler from various perspectives. The forces required to activate the various functions of the stapler were measured using strain gage force transducers. Four stacked layers of 4 mm thick foam were used as a tissue surrogate for all clamping and firing operations.

RESULTS: The physical dimensions varied between staplers and direct correlations were difficult because of the inherent differences in design and functionality. Except for the finger reach associated with staple firing for the Echelon, the dimensions of each stapler were observed to fall within published anthropometric limits for males and females. The clamping lever motion of the two manual staplers favorably traverses a grip span ranging from 2 to 4.5 inches, which allows for the greatest use of grip strength in both male and female users. The activation forces for each of the stapler components also varied and considerable differences in force levels were observed between the stapler designs. Both manual staplers subject its users to repeated grip forces in excess of 20 pounds during staple firing and blade retraction functions, while published literature indicates that maximum grip force levels should not exceed 25 pounds when designing a hand tool for use by 95 percent of the female population.

CONCLUSION: Although the physical characteristics of the three stapler designs were generally within the recommended anthropometric limits for males and females, the dimensions of the manual staplers are not adequately suited for use by male or female surgeons having a glove size less than 6.5, as reported in the literature. The presence of high activation force levels generates significant biomechanical risks to the surgeon, especially if coupled with awkward postures, strained movements, and/or one-handed operations. The slightly-heavier powered stapler demonstrated negligible staple firing and blade retraction forces when compared to the manual staplers, which may increase instrument stability and decrease surgeon fatigue. If properly designed, powered instruments may help to control, and possibly eliminate, some of the musculoskeletal issues inherent to minimally-invasive surgeries.
 


Session Number: Poster – Poster Presentations
Program Number: P412
View Poster

987

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons