Development of laparoscopic instruments

Laparoscopy has important consequences for the functioning of the surgeon, affecting both his/her perception and manipulation capabilities. To be able to judge the perception and manipulation aspects of laparoscopic instrumen ts, a thorough insight into the functioning of the laparoscopic surgeon is needed, and a realistic model of the operation process should be a starting point for every new design. In addition, it is efficient to use observatio nal methods to gain insight into the most important limitations encountered in clinical practice and into the effect of an alternative design. To achi eve simplification of the laparoscopic procedure, innovative and unconventi onal solutions are needed. Thus, the design strategy for laparoscopic instr uments is important. Passive and active design strategies, and force- and m otion-directed design concepts are reviewed, and their characteristics are compared in view of minimally invasive application. Three design examples a re presented and the related design strategy is discussed in each case. The se examples are: a laparoscopic grasper with force perception, a passive in strument positioner and a force-controlled robotic system with active const raints. Future trends in the development of laparoscopic instruments are al so discussed.