Novel modular 2-DOF microsurgical forceps for transoral laser microsurgeries: Ergonomic design and preliminary evaluation.

Transoral Laser Microsurgeries (TLM) demand a great level of control and precision in intraoperative tissue manipulation. The optimal eradication of the diseased tissue is possible only with coordinated control of the laser aiming for incision and the microsurgical tools for orienting and stretching the tissue. However, the traditional microsurgical tools are long, single purpose, one degree-of-freedom (DOF), rigid tools with small range of motion and a normal grasping handle inducing non-ergonomic usage. This paper presents a novel, modular microsurgical tool to overcome the challenges of the traditional tools and improve the surgeon-tool usage experience. The novel design adds a rotational DOF to expand the reach and functionality of the tool. The device is provided with an ergonomic grasping handle that avoids extreme wrist excursions and is capable of adapting to the variety of tools used in TLM within the same design. The performance of the new microsurgical tool was evaluated through a subjective assessment with both medical students and expert surgeons. The evaluation demonstrated a general acceptance of the new forceps tool, with the expert surgeons providing positive appraisals for the improved functionality and user experience with the tool, which indicates towards the potential suitability of the device for TLM. The parameters assessed in the preliminary evaluation not only provide a sense of the advantages of the novel design, but also guide future evolution of the tool design.