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.

Methods:

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 re-assembly experiment to validate the modularity, and in a steering experiment using a custom made set-up for to validate steering.

Results:

A new steerable SATA-LRS instrument was developed with the ability to exchange end-effectors through a dis-assembly of the shafts. Experiments showed an average 34 and 90 seconds for complete dis- and re-assembly, 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.

Conclusions:

A novel instrument platform with articulating and rotating end-effector was designed for LRS. Within a minute the SATA-LRS can be dis-assembled 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.