This report aims to establish evidence-based guidelines for ergonomic improvements in laparoscopic surgery by evaluating various instrument handle designs. A total of 23 studies met the inclusion criteria, primarily consisting of simulation-based randomized crossover trials with small sample sizes and diverse outcome measures. The available evidence on laparoscopic needle driver handle designs is limited, and no configuration has been conclusively shown to be superior. Regarding graspers, some studies suggest that inline or intermediate handle configurations may promote more neutral wrist postures and decrease forearm muscle activation compared to pistol-grip designs; however, these findings are inconsistent across different studies. Evaluations of electrosurgical devices indicate that ergonomic performance may depend on handle geometry, placement of activation buttons, and surgeon-specific factors such as hand size. Despite these insights, no single device consistently demonstrates ergonomic superiority. Overall, current evidence supporting specific handle designs for optimizing ergonomics in laparoscopic instruments remains limited and heterogeneous. Conventional instruments are generally suitable for routine procedures, while alternative designs could be considered in specific cases where ergonomic benefits are apparent. The review underscores the need for further prospective clinical research utilizing standardized ergonomic assessment metrics. Such studies are essential to inform the development of evidence-based instrument designs that effectively reduce musculoskeletal strain and improve surgeon comfort during laparoscopic procedures.
Reference:
AAGL Instrument and Handle Selection for Ergonomic Optimization in Laparoscopic Surgery Guideline Summary – Guideline Central. (n.d.). https://www.guidelinecentral.com/guideline/5213606/
