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 15 mm can provide a torque resistance of 1.9 Ncm. Finally, a full morcellation instrument concept design is provided.
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March 2017
Research-Article
A Laparoscopic Morcellator Redesign to Constrain Tissue Using Integrated Gripping Teeth
E. A. Arkenbout,
E. A. Arkenbout
Biomechanical Engineering Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: e.a.arkenbout@tudelft.nl
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: e.a.arkenbout@tudelft.nl
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L. van den Haak,
L. van den Haak
Department of Gynecology,
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: L.van_den_Haak@lumc.nl
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: L.van_den_Haak@lumc.nl
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M. Penning,
M. Penning
Life Science and Technology Department,
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: maxime_penning@hotmail.com
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: maxime_penning@hotmail.com
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E. Rog,
E. Rog
Maritime Transport Technology Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: ellemijnrog@gmail.com
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: ellemijnrog@gmail.com
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A. Vierwind,
A. Vierwind
Life Science and Technology Department,
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: amandavierwind@hotmail.com
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: amandavierwind@hotmail.com
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L. E. van Cappelle,
L. E. van Cappelle
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: l.e.vancappelle@gmail.com
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: l.e.vancappelle@gmail.com
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F. W. Jansen,
F. W. Jansen
Department of Gynecology,
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: f.w.jansen@lumc.nl
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: f.w.jansen@lumc.nl
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J. C. F. de Winter
J. C. F. de Winter
Biomechanical Engineering Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: J.C.F.deWinter@tudelft.nl
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: J.C.F.deWinter@tudelft.nl
Search for other works by this author on:
E. A. Arkenbout
Biomechanical Engineering Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: e.a.arkenbout@tudelft.nl
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: e.a.arkenbout@tudelft.nl
L. van den Haak
Department of Gynecology,
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: L.van_den_Haak@lumc.nl
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: L.van_den_Haak@lumc.nl
M. Penning
Life Science and Technology Department,
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: maxime_penning@hotmail.com
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: maxime_penning@hotmail.com
E. Rog
Maritime Transport Technology Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: ellemijnrog@gmail.com
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: ellemijnrog@gmail.com
A. Vierwind
Life Science and Technology Department,
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: amandavierwind@hotmail.com
Faculty of Applied Sciences,
Lorentzweg 1,
Delft 2628 CJ, The Netherlands
e-mail: amandavierwind@hotmail.com
L. E. van Cappelle
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: l.e.vancappelle@gmail.com
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: l.e.vancappelle@gmail.com
F. W. Jansen
Department of Gynecology,
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: f.w.jansen@lumc.nl
Leiden University Medical Center,
Albinusdreef 2,
Leiden 2333 ZA, The Netherlands
e-mail: f.w.jansen@lumc.nl
J. C. F. de Winter
Biomechanical Engineering Department,
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: J.C.F.deWinter@tudelft.nl
Faculty of Mechanical, Maritime, and
Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: J.C.F.deWinter@tudelft.nl
1Corresponding author.
Manuscript received March 17, 2016; final manuscript received September 19, 2016; published online December 21, 2016. Assoc. Editor: Carl Nelson.
J. Med. Devices. Mar 2017, 11(1): 011005 (13 pages)
Published Online: December 21, 2016
Article history
Received:
March 17, 2016
Revised:
September 19, 2016
Citation
Arkenbout, E. A., van den Haak, L., Penning, M., Rog, E., Vierwind, A., van Cappelle, L. E., Jansen, F. W., and de Winter, J. C. F. (December 21, 2016). "A Laparoscopic Morcellator Redesign to Constrain Tissue Using Integrated Gripping Teeth." ASME. J. Med. Devices. March 2017; 11(1): 011005. https://doi.org/10.1115/1.4034882
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