A laparoscopic morcellator redesign to constrain tissue using integrated gripping teeth

E. A. Arkenbout; L. van den Haak; Maxime Penning; Ellemijn Rog; Amanda Vierwind; L.E. van Capelle; F. W. Jansen; J. C F de Winter

doi:10.1115/1.4034882

A laparoscopic morcellator redesign to constrain tissue using integrated gripping teeth

E. A. Arkenbout^*, L. van den Haak, Maxime Penning, Ellemijn Rog, Amanda Vierwind, L.E. van Capelle, F. W. Jansen, J. C F de Winter

^*Corresponding author for this work

Research output: Contribution to journal › Article › Scientific › peer-review

1 Citation (Scopus)

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Abstract

Laparoscopic hysterectomy is a procedure that involves the removal of the uterus through an abdominal keyhole incision. Morcellators have been specifically designed for this task, but their use has been discouraged by the food and drug administration (FDA) since November 2014 because of risks of cancerous tissue spread. The use of laparoscopic bags to catch and contain tissue debris has been suggested, but this does not solve the root cause of tissue spread. The fundamental problem lies in the tendency of the tissue mass outside the morcellation tube to rotate along with the cutting blade, causing tissue to be spread through the abdomen. This paper presents a bio-inspired concept that constrains the tissue mass in the advent of its rotation in order to improve the overall morcellation efficacy and reduce tissue spread. A design of gripping teeth integrated into the inner diameter of the morcellation tube is proposed. Various tooth geometries were developed and evaluated through an iterative process in order to maximize the gripping forces of these teeth. The maximum gripping force was determined through the measurement of force-displacement curves during the gripping of gelatin and bovine tissue samples. The results indicate that a tooth ring with a diameter of 15mm can provide a torque resistance of 1.9 Ncm. Finally, a full morcellation instrument concept design is provided.

Original language	English
Article number	011005
Number of pages	13
Journal	Journal of Medical Devices
Volume	11
Issue number	1
DOIs	https://doi.org/10.1115/1.4034882
Publication status	Published - 2017

Bibliographical note

Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care

Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.

Keywords

Laparoscopic devices
Minimally invasive surgery
Morcellation
Tissue constraining
Tissue spread

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1115/1.4034882

med_011_01_011005Final published version, 4.22 MB

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title = "A laparoscopic morcellator redesign to constrain tissue using integrated gripping teeth",

abstract = "Laparoscopic hysterectomy is a procedure that involves the removal of the uterus through an abdominal keyhole incision. Morcellators have been specifically designed for this task, but their use has been discouraged by the food and drug administration (FDA) since November 2014 because of risks of cancerous tissue spread. The use of laparoscopic bags to catch and contain tissue debris has been suggested, but this does not solve the root cause of tissue spread. The fundamental problem lies in the tendency of the tissue mass outside the morcellation tube to rotate along with the cutting blade, causing tissue to be spread through the abdomen. This paper presents a bio-inspired concept that constrains the tissue mass in the advent of its rotation in order to improve the overall morcellation efficacy and reduce tissue spread. A design of gripping teeth integrated into the inner diameter of the morcellation tube is proposed. Various tooth geometries were developed and evaluated through an iterative process in order to maximize the gripping forces of these teeth. The maximum gripping force was determined through the measurement of force-displacement curves during the gripping of gelatin and bovine tissue samples. The results indicate that a tooth ring with a diameter of 15mm can provide a torque resistance of 1.9 Ncm. Finally, a full morcellation instrument concept design is provided.",

keywords = "Laparoscopic devices, Minimally invasive surgery, Morcellation, Tissue constraining, Tissue spread",

author = "Arkenbout, {E. A.} and {den Haak}, {L. van} and Maxime Penning and Ellemijn Rog and Amanda Vierwind and {van Capelle}, L.E. and Jansen, {F. W.} and {de Winter}, {J. C F}",

note = "Green Open Access added to TU Delft Institutional Repository {\textquoteleft}You share, we take care!{\textquoteright} – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.",

year = "2017",

doi = "10.1115/1.4034882",

language = "English",

volume = "11",

journal = "Journal of Medical Devices",

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A laparoscopic morcellator redesign to constrain tissue using integrated gripping teeth. / Arkenbout, E. A.; den Haak, L. van; Penning, Maxime; Rog, Ellemijn; Vierwind, Amanda; van Capelle, L.E.; Jansen, F. W.; de Winter, J. C F.

In: Journal of Medical Devices, Vol. 11, No. 1, 011005, 2017.

Research output: Contribution to journal › Article › Scientific › peer-review

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AU - Arkenbout, E. A.

AU - den Haak, L. van

AU - Penning, Maxime

AU - Rog, Ellemijn

AU - Vierwind, Amanda

AU - van Capelle, L.E.

AU - Jansen, F. W.

AU - de Winter, J. C F

N1 - Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.

PY - 2017

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AB - Laparoscopic hysterectomy is a procedure that involves the removal of the uterus through an abdominal keyhole incision. Morcellators have been specifically designed for this task, but their use has been discouraged by the food and drug administration (FDA) since November 2014 because of risks of cancerous tissue spread. The use of laparoscopic bags to catch and contain tissue debris has been suggested, but this does not solve the root cause of tissue spread. The fundamental problem lies in the tendency of the tissue mass outside the morcellation tube to rotate along with the cutting blade, causing tissue to be spread through the abdomen. This paper presents a bio-inspired concept that constrains the tissue mass in the advent of its rotation in order to improve the overall morcellation efficacy and reduce tissue spread. A design of gripping teeth integrated into the inner diameter of the morcellation tube is proposed. Various tooth geometries were developed and evaluated through an iterative process in order to maximize the gripping forces of these teeth. The maximum gripping force was determined through the measurement of force-displacement curves during the gripping of gelatin and bovine tissue samples. The results indicate that a tooth ring with a diameter of 15mm can provide a torque resistance of 1.9 Ncm. Finally, a full morcellation instrument concept design is provided.

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A laparoscopic morcellator redesign to constrain tissue using integrated gripping teeth

Abstract

Bibliographical note

Keywords

UN SDGs

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