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

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 ex-pensive telesurgery systems, and much cheaper but less user-friendly steerable mechanical instruments. However, ergonomics of such instruments still need improvement 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 virtual reality simulator. Results show that this solution improves ergonomics, demanding less wrist flexion and deviation and elbow elevation, while offering gesture performance similar to a robotic dextrous instrument with standard pistol-like handle configuration.