FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to surgery, to a method for manufacturing individual ergonomic handles of laparoscopic surgical instruments using three-dimensional printing, and can be used for practical use in conditions of surgical hospitals of wide profile. Method of producing individual ergonomic handles of laparoscopic surgical instruments using three-dimensional printing on a physiological position of a left or right surgeon, similar to when a round object is in hand, is simulated using a fast-setting plastic polymer material, e.g. polycaprolactan, two branches with holes of individual handle of laparoscopic surgical instrument, one of which is intended for arrangement of first finger of individual surgeon's hand and second one for placement of second-fifth fingers of individual surgeon's hand. A model of a branch for the first finger of a surgeon is formed by a nail phalange of its first finger with provision of the maximum possible area for the dental and palmar surfaces of the individual surgeon's hand and the length of the branch, equal to the distance between the nail phalanx of the first finger of the individual hand of the surgeon and the metacarpophalangeal joint of the second finger of the individual hand of the surgeon. Model of the branch for the second-fifth fingers of the individual hand of the surgeon is shaped similar to figure 9, wherein for the second finger of the individual surgeon's hand an additional contact area is formed above the opening of digit 9, for the third and fourth fingers of the individual hand of the surgeon, contact is formed in the opening of digit 9 and for the fifth finger of the individual hand of the surgeon contact is formed in the curl of digit 9 with provision of the length of the branch exceeding by 3–4 cm the width of the individual hand of the surgeon at the level of metacarpal phalanges from the second by fifth finger of individual surgeon brush. Produced casts of branches are scanned in three-dimensional scanner with obtaining of 3D-model, computer processing of 3D-model of handle is performed, surface is smoothed and the obtained model is combined with any type of hinged connection and assembly of laparoscopic instrument. Smoothing model of handle from biologically compatible and non-toxic polymer material is produced using printing on 3D printer, repeating all individual anatomical features of wrist of individual surgeon's hand, which is equipped with a drive for manipulating through a lever mechanism an actuator and a laparoscopic instrument actuator attachment assembly.
EFFECT: use of the invention enables creating ergonomic handles of laparoscopic surgical instruments taking into account individual features of the surgeon's hand providing absence of painful sensations or compression of surgeon's nerves and vessels during prolonged use.
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Authors
Dates
2019-11-21—Published
2018-12-21—Filed