Effectiveness of grasping and duration of clamping using laparoscopic graspers

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Abstract
Manipulating tissue with laparoscopic forceps is more difficult than using the hands. This study investigates the effectiveness of grasping and the duration of tissue-clamping using laparoscopic forceps. Video recordings of 10 laparoscopic colectomies and 15 cholecystectomies were analyzed using time-action analysis. The results indicated that 62% of the grasping actions were successful: the tissue was clamped sufficiently to perform an action. Of all the clamping actions on the colon, 10% were repeated actions. On the gallbladder 7% were repeated actions. The bowel slipped out of the grasper in 7% of the clamping actions, whereas the gallbladder slipped in 17%. In 89%, the colon was clamped less than 1 min. The maximum clamping time was 7 min for the colon, and 55 min for the gallbladder. The low percentage of successful grasping actions indicates that the design of laparoscopic graspers is not optimal.