A Retractable Six-Prong Laparoscopic Grasper for Laparoscopic Myomectomy-Reference-Cited by-同舟云学术

A Retractable Six-Prong Laparoscopic Grasper for Laparoscopic Myomectomy

Published:2022-03-31 Issue:3 Volume:16 Page:
ISSN:1932-6181
Container-title:Journal of Medical Devices
language:en
Short-container-title:

Author:

Butters Brenden¹,Fernández-Galiana Álvaro²,Wollin Daniel³,Traverso Giovanni⁴,Slocum Alexander⁵,Petrozza John⁶

Affiliation:

1. Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139

2. Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139; Bioengineering Department, Imperial College London, London SW7 2BX, UK

3. Integrated Design and Management, Massachusetts Institute of Technology, Cambridge, MA 02139; Division of Urologic Surgery, Brigham and Women's Hospital, Boston, MA 02115; Harvard Medical School, Boston, MA 02115

4. Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139; Division of Gastroenterology, Brigham and Women's Hospital, Boston, MA 02115; Harvard Medical School, Boston, MA 02115

5. Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139

6. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital Fertility Center, Boston, MA 02114; Harvard Medical School, Boston, MA 02115

Abstract

Abstract The fixation and manipulation of fibroids during laparoscopic myomectomy is a persistent issue for gynecologic surgeons. In this paper, we present a laparoscopic grasper that, through a sheath-based deployment mechanism, opens into a larger multitoothed grasper within the patient and collapses back for removal. Due to the increased number of contact points with the tumor, the expanded grasper allows for reliable fixation, aiding in manipulation during excision. We describe the nature-inspired design of the grasper from a physical foundation, establish the design theory and practical issues, and present manufacturing and testing of a full-scale 5 mm grasper. The unit was tested on synthetic fibroid models and was able to sustain a 50% higher load before tearing than a common single-tooth tenaculum. This development not only promises to improve fibroid fixation in myomectomy but also its design could be adapted to aid in the fixation of other difficult tissues in laparoscopic surgery.

Publisher

ASME International

Subject

Biomedical Engineering,Medicine (miscellaneous)

Link

https://asmedigitalcollection.asme.org/medicaldevices/article-pdf/16/3/031003/6869215/med_016_03_031003.pdf

Reference19 articles.

1. High Cumulative Incidence of Uterine Leiomyoma in Black and White Women: Ultrasound Evidence;Am. J. Obstet. Gynecol.,2003

2. Laparoscopic Myomectomy—The Gold Standard;Gynecol. Minimally Invasive Ther.,2014

3. The Indications, Surgical Techniques, and Limitations of Laparoscopic Myomectomy;JSLS,2003

4. Laparoscopic Myomectomy: The Current Status;Curr. Opin. Obstet. Gynecol.,2003

5. Dilute Ornitin Vasopressin and a Myoma Drill for Laparoscopic Myomectomy;J. Am. Assoc. Gynecol. Laparosc.,1999