钳齿形貌对腹腔镜夹钳安全性的影响

目的:对比不同齿形腹腔镜夹钳的夹持效果，以确定其各自安全夹持组织的能力，为夹钳优化设计提供参考。方法:通过ANSYS有限元分析，对比梯形齿、钉形齿、直角楔形齿、等腰楔形齿4种齿形钳头压缩量和牵拉效果关系，并通过应变云图分析夹持能力不同的原因。以钳头夹持组织不损伤、不滑脱为判断标准，评价各齿形夹持能力。结果:直角楔形齿具有最优越的安全夹持能力，钉形齿最容易损伤组织，且其安全牵拉能力最差；梯形齿安全牵拉能力与等腰楔形齿相近，但等腰楔形齿安全压缩量更优。齿数对牵拉效果影响明显。结论:腹腔镜夹钳夹持能力取决于钳齿形貌和齿数，安全夹持性由最大应力和钳制能力共同决定。峰值应力大的齿形并不表示夹持能力强，牵拉能力应考虑钳制变形能力。

Effects of teeth profile on the safety of laparoscopic grasper

Abstract: Objective To analyze the clamping capabilities of laparoscopic graspers with different teeth profiles during tissue clamping operation, thereby providing valuable reference for the design of grasper. Methods ANSYS was used for finite element analysis. The relationships between the compression and the traction effect of 4 kinds of teeth profiles (trapezoidal, nail-shaped, right-angled wedge-shaped and isosceles wedge-shaped) were compared, and the reasons for different clamping capabilities were analyzed by strain nephogram. Taking the tissue clamping without damages or slippage as the standard, the clamping capabilities of different teeth profiles were evaluated. Results The right-angled wedge-shaped teeth had the best ability to clamp tissues, while the nail-shaped teeth caused damages to tissues easily and had the worst traction performance. The trapezoidal teeth and isosceles wedge-shaped teeth had similar traction performances, but the compression of isosceles wedge-shaped teeth was better. Moreover, the teeth number had obvious effects on traction performance. Conclusion The clamping capability of laparoscopic grasper depends on the profile and number of teeth and the safety of clamping tissues by laparoscopic grasper is determined by peak stress and clamping capability. The teeth profile with a high peak stress does not mean that the grasper has a strong capability of tissue clamping, and the capability of clamp deformation should be considered in the evaluation of traction capability.