Prehensile atraumatic grasper with intuitive ergonomics

Background: Minimal access surgery (MAS) procedures that require tissue to be grasped are impeded by the design of current instruments. The use of graspers and forceps can result in tissue damage and is highly inappropriate when handling larger organs such as the bowel, liver, and spleen. In addition, current instruments have unnatural handling characteristics. A new type of tissue grasper is presented as a solution to these problems. Methods: The new grasper design was evolved through a process of setting basic requirements and proceeding through cycles of design, construction, evaluation, and redesign. Results: The main features of the new device are prehensile grasping by finger-like jaws, which retain tissue by `capture,' and a novel handle design with intuitive ergonomics. The jaws are interchangeable to suit differing surgical tasks and the handle and trigger mechanism are designed so that the surgeon's forefinger movement mirrors the instrument jaw action. The grasper has been used in 32 MAS procedures with no indications of trauma. Conclusions: A grasper that functions by capture has been demonstrated to be an effective solution for atraumatic tissue handling during many MAS procedures. Received: 3 February 1997/Accepted: 28 February 1997