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Surgical Endoscopy

Published in:

01-03-2005 | Original article

Hand movements in laparoscopic suturing: a simple vector analysis

Authors: A. J. Hansen, R. T. Schlinkert

Published in: Surgical Endoscopy | Issue 3/2005

Abstract

Background

Laparoscopic suturing is a complex task that is vital to the performance of many advanced laparoscopic procedures. Mastery can be difficult and problematic for surgical trainees.

Methods

We present a description of hand movements in laparoscopic suturing. Complex maneuvers are simplified into linear motions using vectors. The analysis is intended to be a tool for training in the art of laparoscopic surgery.

Results

Linear hand movements in the x and y axes produce opposite motions at the instrument tip. Position along the z axis influences the extent of hand movement relative to the instrument tip. Rotational movements of the hand produce an equal rotation of the instrument tip. Revolution is a complex motion that combines movements in x and y axes. Vector analysis reveals that the arc of revolution must be reversed to produce the desired needle motion.

Conclusions

A conceptual understanding of hand-movement vectors facilitates the efficient mastery of the complex skills required for laparoscopic suturing.

Berguer, R 1998Surgical technology and the ergonomics of laparoscopic instrumentsSurg Endosc12458462CrossRefPubMed

Berguer, R, Gerber, S, Kilpatrick, G, Beckley, D 1998An ergonomic comparison of in-line vs pistol-grip handle configuration in a laparoscopic grasperSurg Endosc12805808CrossRefPubMed

Frede, T, Stock, C, Renner, C, Budair, Z, Abdel-Salam, Y, Rassweiler, J 1999Geometry of laparoscopic suturing and knotting techniquesJ Endourol13191198PubMed

Frede, T, Stock, C, Rassweiler, JJ, Alken, P 2000Retroperitoneoscopic and laparoscopic suturing: tips and strategies for improving efficiencyJ Endourol14905913; discussion 913-914 PubMed

Joice, P, Hanna, GB, Cuschieri, A 1998Ergonomic evaluation of laparoscopic bowel suturingAm J Surg176373378CrossRefPubMed

Patkin, M, Isabel, L 1995Ergonomics, engineering and surgery of endosurgical dissectionJ R Coll Surg Edinb40120132PubMed

Seki, S 1988Techniques for better suturingBr J Surg7511811184PubMed

Seki, S 1994The “left-hand rule” in directional changes of the needle holder with different needle grips: suturing technique in a restricted operating spaceIn Surg79172175

Seki, S, Iwamoto, H, Osaki, H, Komoto, Y 1993The surgeon’s technical skill in suturing: an analysis of the actual suture tracksSurg Today23800806CrossRefPubMed

10.

Szabo, Z (1999) “Principals of tissue approximation” In: Scott-Conner, CEH (ed), The SAGES manual: fundamentals of laparoscopy and GI endoscopy, Springer, New York, pp 68–81

11.

Szabo, Z, Hunter, J, Berci, G, Sackier, J, Cuschieri, A 1994Analysis of surgical movements during suturing in laparoscopyEndosc Surg Allied Technol215561

Title: Hand movements in laparoscopic suturing: a simple vector analysis
Authors: A. J. Hansen
R. T. Schlinkert
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 3/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-004-8229-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Hand movements in laparoscopic suturing: a simple vector analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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