SATA-LRS: A modular and novel steerable hand-held laparoscopic instrument platform for low-resource settings

Background: Hospitals in low resource settings (LRS) can benefit from modern laparoscopic methodologies. However, cleaning, maintenance and costs requirements play a stronger role while training and technology are less available. Steerable laparoscopic instruments have additional requirements in these settings and need extra identified adaptations in their design. Method: Several modular detachability and tip steerability features were applied to the SATA-LRS instrument platform designed specifically for LRS. Ten subjects participated a dis-and reassembly experiment to validate the modularity, and in a steering experiment using a custom made set-up to validate steering. Results: A new steerable SATA-LRS instrument was developed with the ability to exchange end-effectors through a disassembly of the shafts. Experiments showed an average 34 and 90 s for complete dis-and reassembly, respectively. Participants were able to handle the instrument independently after a single demonstration and 4 rounds of repetitions. Precise tip-target alignment in the box set-up showed a very short learning-curve of 6 repetitions. Conclusion: A novel instrument platform with articulating and rotating end-effector was designed for LRS. Within a minute the SATA-LRS can be disassembled to component level for inspection, cleaning, maintenance and repair, and can be autonomously reassembled by novices after a minimal training. The modular buildup is expected to reduce purchasing and repair costs. The instrument has been shown intuitive by use without extensive training.

Automated summary

A steerable laparoscopic instrument platform with modular detachability and tip steerability features was designed for low resource settings. The experiments showed that the instrument platform had good modularity and maneuverability. The results indicated short assembly and disassembly time and the ability for novices to handle the instrument independently after minimal training. The design of the instrument is expected to reduce purchasing and repair costs.