Scalpel Handle Research Articles

Three-Dimensional printed instruments used in a Septoplasty: A new paradigm in Surgery.

ObjectiveThree‐dimensional (3D) printing has been rapidly adopted by different surgical disciplines. It has shown itself to have improved outcomes in education, pre‐operative planning, and reconstruction. However, using 3D printing to create surgical instruments is a niche within the literature that has not yet been fully explored. The authors present a study in which it is hypothesized that 3D printing surgical instruments can be utilized successfully within ENT surgery.MethodsAs one of the most common ENT operations worldwide, a septoplasty was chosen as the procedure to provide proof of concept. For the septoplasty, five instruments were printed: a scalpel handle, needle holders, toothed forceps, a Cottle/Freer elevator, and a Killian's speculum. The entire set took 224 minutes on average to print, weighed 36 g, and only used approximately 86 pence ($1.20 USD) worth of polylactic acid plastic to create.ResultsAll steps in performing a septoplasty on a human cadaver with the 3D printed tools were possible and were undertaken successfully. This yielded a similar outcome to using stainless steel with the added benefit of there being a large reduction in cost and the ability for rapid customization according to the surgeon's preferences.ConclusionAs technology and mainstream interest in 3D printing develops, the availability of more precise Computer‐Aided Design software will allow for more complex designs of tools to be created. Currently, 3D printing has been shown to be a promising method from which future surgical tools can be fashioned to meet the complex, dynamic demands of surgery.Level of EvidenceN/A.

Design and application of a retractable scalpel handle

The scalpel is the most practical tool for surgeons. The traditional scalpel is a blade with a split handle, but the length of the blade cannot be adjusted, and it is easy to scratch medical staff. In order to solve the above problems, a retractable scalpel handle was designed by the medical staffs of department of general surgery, Affiliated Hospital of Yangzhou University (Clinical Teaching Hospital of Dalian Medical University), and obtained the National Utility Model Patent of China (ZL 2019 2 0203154.9). The telescopic scalpel adopted the design of rotary telescopic sleeve and threaded column handle to achieve the purpose of built-in blade. By rotating the handle at one end of the handle, the length of the surgical blade extending out of the sleeve could be adjusted according to the actual needs. The structure of the device is simple and easy to operate. The adjustable blade length could also achieve the purpose of accurate operation while effectively avoiding the injury of medical personnel during the operation.

Technological innovation and patent transformation in rectal cancer surgery

Surgery for rectal cancer has obtained quick improvement in techniques and concepts in recent years but still has challenging areas. Colorectal surgeons always seek to make operations clearer and easier, so that surgery can be safer and less time-consuming while guaranteeing surgical goals. With this purpose, our team have explored to make innovations in operations for rectal cancer and translate relevant patents from 2009. We summarize our achievements in this article as follows: (1) Reverse Miles operation (perineal operation first then laparoscopic abdominal operation) with two relevant patents-specialized instruments bag for laparoscopic operations (patent number ZL201520442331.0) and accessory spotlight for ultrasound scalpel (patent number ZL20102 0137689.X). (2) Laparoscopic sphincter-saving surgery for low rectal cancer through marker meeting approach with two patents-vacuum rectal drainage tube with functions of irrigation and ventilation (patent number ZL201520374385.8) and sterile sleeve cover of ultrasound scalpel handle (patent number ZL201920648102.2). (3) Laparoscopic radical resection of colorectal cancer and natural orifice specimen extraction. Different methods were designed according to the location of the tumor that classified as 20-40 cm, 10-20 cm and 5-10 cm to anus. Two relevant patents were specialized instruments for natural orifice specimen extraction (patent application number ZL2017101480141) and plastic film sleeve for natural orifice specimen extraction (patent application number ZL 201921169857.0). Reformation of surgical technique and innovation of surgical instruments should be conducted by surgeons with innovative thinking who always seek the way to translate ideas to patents and then real products to promote surgical treatment.

Clinical effectiveness of super pulsed carbon dioxide fractional laser debridement surgery in treating chronic wounds

Objective: To investigate the clinical effectiveness of super pulsed carbon dioxide fractional laser debridement surgery on the treatment of chronic wounds. Methods: From December 2018 to May 2019, 37 patients with chronic wounds who met the inclusion criteria were admitted to the Affiliated Hospital of Southwest Medical University for a prospective randomized controlled study. Using the random number table, the patients were divided into surgical debridement group (19 patients, 4 males and 15 females, aged (58±16) years, 25 wounds) and laser debridement group (18 patients, 9 males and 9 females, aged (58±10) years, 23 wounds). In patients of surgical debridement group, oedematous and aging granulation tissue was scraped from the wound by scalpel handle or curet, and the residual necrotic tissue was removed by sharp surgical instruments. In patients of laser debridement group, oedematous and aging granulation tissue and necrotic tissue was removed by super pulsed carbon dioxide fractional laser therapeutic machine, laser gasification debridement was performed repeatedly till fresh normal tissue layer observed. In patients of the two groups, according to the wound in the first 3 d after the first debridement, debridement dressing was performed twice at least as before, then wound debridement dressing was performed once every 1 to 4 days as before according to the wound conditions. The wound healing rates on 7, 14, 21, and 28 d after the first debridement were calculated. The positive rates of bacterial culture of wounds before and after the first debridement were calculated. The color and texture of the wound granulation tissue before the first debridement and on 7, 14, and 28 d after the first debridement were observed and scored. The pain scores before every debridement, during every debridement, and after every debridement dressing change were evaluated by visual analogue scale. The times of debridement dressing change were recorded. Data were statistically analyzed with two independent sample t test, analysis of variance for repeated measurement, Fisher's exact probability test, Mann-Whitney U test, and Bonferroni correction. Results: (1) On 7, 14, 21, and 28 d after the first debridement, the wound healing rates of patients in laser debridement group (29.5% (24.1%, 36.0%), 47.1% (42.7%, 62.4%), 71.4% (62.2%, 76.8%), and 88.6% (79.2%, 96.3%) were significantly higher than those of surgical debridement group (1.6% (1.0%, 12.8%), 12.7% (2.0%, 16.6%), 24.5% (8.9%, 45.5%), 43.9% (23.2%, 70.8%), Z=3.477, 3.553, 2.721, 2.193, P<0.05 or P<0.01). (2) Before the first debridement, the positive rates of bacterial culture of wounds in patients of laser debridement group and surgical debridement group were 92% (23/25) and 91% (21/23), respectively, which were similar (P>0.05). After the first debridement, the positive rate of bacterial culture of wounds of patients in surgical debridement group was 64% (16/25), which was significantly higher than 13% (3/23) of laser debridement group (P<0.01). (3) On 7, 14, and 28 d after the first debridement, the scores of color and texture of wound granulation tissue of patients in laser debridement group were significantly higher than those of surgical debridement group (Z=3.420, 5.682, 6.142, 4.461, 5.337, 4.458, P<0.01). (4) The pain scores during every debridement and after every debridement dressing change in patients of laser debridement group were significantly lower than those of surgical debridement group (t=2.847, 5.046, P<0.05 or P<0.01). (5) The time of debridement dressing change in laser debridement group was 8.0 (7.0, 10.0) times, which was significantly less than 10.0 (9.5, 12.5) times in surgical debridement group (Z=2.261, P<0.05). Conclusions: Compared with traditional surgical debridement method, super pulsed carbon dioxide fractional laser debridement surgery is more effective in treating patients with chronic wounds. Laser debridement makes the wound healing more efficiently with reduced pain and better infection control; significantly reduces the number of dressing changes, and is especially suitable for the wound treatment in outpatients.

Dr Michael Bell: A Surgeon With Boundless Ingenuity

Dr Michael Bell was born in Kingston, Ontario, on October 14, 1944. He was always a curious child who exhibited a tendency toward innovation and experimentation. Dr Bell was accepted into the MD program at the University of Toronto graduating in 1969 before completing his plastic surgery residency there. Dr Bell accepted a position bringing hand and microsurgery expertise to the University of Ottawa in 1976. He pioneered the widespread use of local anesthetic for surgery and developed an innovative relationship with Leonard Lee of Lee Valley tools. Canica Design created several surgical products, including an enhanced design on the traditional scalpel handle and wound closure devices. Dr Bell had a passion for making improvements to enable surgeons to advance patient care. He encourages a philosophy of critical thinking that contributes to continued design in plastic surgery. Dr Bell continues to design and craft new devices with alumni of the Lee Valley Tools team.

3D Printed Surgical Instruments: The Design and Fabrication Process.

3D printing is an additive manufacturing process allowing the creation of solid objects directly from a digital file. We believe recent advances in additive manufacturing may be applicable to surgical instrument design. This study investigates the feasibility, design and fabrication process of usable 3D printed surgical instruments. The computer-aided design package SolidWorks (Dassault Systemes SolidWorks Corp., Waltham MA) was used to design a surgical set including hemostats, needle driver, scalpel handle, retractors and forceps. These designs were then printed on a selective laser sintering (SLS) Sinterstation HiQ (3D Systems, Rock Hill SC) using DuraForm EX plastic. The final printed products were evaluated by practicing general surgeons for ergonomic functionality and performance, this included simulated surgery and inguinal hernia repairs on human cadavers. Improvements were identified and addressed by adjusting design and build metrics. Repeated manufacturing processes and redesigns led to the creation of multiple functional and fully reproducible surgical sets utilizing the user feedback of surgeons. Iterative cycles including design, production and testing took an average of 3days. Each surgical set was built using the SLS Sinterstation HiQ with an average build time of 6h per set. Functional 3D printed surgical instruments are feasible. Advantages compared to traditional manufacturing methods include no increase in cost for increased complexity, accelerated design to production times and surgeon specific modifications.

3D Printed Surgical Instruments Evaluated by a Simulated Crew of a Mars Mission.

The first space-based fused deposition modeling (FDM) 3D printer became operational in 2014. This study evaluated whether Mars simulation crewmembers of the Hawai'i Space Exploration Analog and Simulation (HI-SEAS) II mission with no prior surgical experience could utilize acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments FDM 3D printed on Earth to complete simulated surgical tasks. This study sought to examine the feasibility of using 3D printed surgical tools when the primary crew medical officer is incapacitated and the back-up crew medical officer must conduct a surgical procedure during a simulated extended space mission. During a 4 mo duration ground-based analog mission, five simulation crewmembers with no prior surgical experience completed 16 timed sets of simulated prepping, draping, incising, and suturing tasks to evaluate the relative speed of using four ABS thermoplastic instruments printed on Earth compared to conventional instruments. All four simulated surgical tasks were successfully performed using 3D printed instruments by Mars simulation crewmembers with no prior surgical experience. There was no substantial difference in time to completion of simulated tasks with control vs. 3D printed sponge stick, towel clamp, scalpel handle, and toothed forceps. These limited findings support further investigation into the creation of an onboard digital catalog of validated 3D printable surgical instrument design files to support autonomous, crew-administered healthcare on Mars missions. Future work could include addressing sterility, biocompatibility, and having astronaut crew medical officers test a wider range of surgical instruments printed in microgravity during actual surgical procedures. Wong JY, Pfahnl AC. 3D printed surgical instruments evaluated by a simulated crew of a Mars mission. Aerosp Med Hum Perform. 2016; 87(9):806-810.

Ultra-Portable Solar-Powered 3D Printers for Onsite Manufacturing of Medical Resources.

The first space-based fused deposition modeling (FDM) 3D printer is powered by solar photovoltaics. This study seeks to demonstrate the feasibility of using solar energy to power a FDM 3D printer to manufacture medical resources at the Mars Desert Research Station and to design an ultra-portable solar-powered 3D printer for off-grid environments. Six solar panels in a 3×2 configuration, a voltage regulator/capacitor improvised from a power adapter, and two 12V batteries in series were connected to power a FDM 3D printer. Three designs were printed onsite and evaluated by experts post analogue mission. A solar-powered 3D printer composed of off-the-shelf components was designed to be transported in airline carry-on luggage. During the analogue mission, the solar-powered printer could only be operated for <1 h/d, but was able to fabricate a functional dental tool, scalpel handle, and customized mallet splint over 2 d. Post analogue mission, an ultra-portable plug-and-play solar-powered 3D printer was designed that could print an estimated 16 dental tools or 8 mallet finger splints or 7 scalpel handles on one fully charged 12V 150Wh battery with a 110V AC converter. It is feasible to use solar energy to power a 3D printer to manufacture functional and personalized medical resources at a Mars analogue research station. Based on these findings, a solar-powered suitcase 3D printing system containing solar panels, 12V battery with charge controller and AC inverter, and back-up solar charge controller and inverter was designed for transport to and use in off-grid communities.

3D Printing of Surgical Instruments for Long-Duration Space Missions

The first off-Earth fused deposition modeling (FDM) 3D printer will explore thermoplastic manufacturing capabilities in microgravity. This study evaluated the feasibility of FDM 3D printing 10 acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments on Earth. Three-point bending tests compared stiffness and yield strength between FDM 3D printed and conventionally manufactured ABS thermoplastic. To evaluate the relative speed of using four printed instruments compared to conventional instruments, 13 surgeons completed simulated prepping, draping, incising, and suturing tasks. Each surgeon ranked the performance of six printed instruments using a 5-point Likert scale. At a thickness of 5.75 mm or more, the FDM printing process had a less than 10% detrimental effect on the tested yield strength and stiffness of horizontally printed ABS thermoplastic relative to conventional ABS thermoplastic. Significant weakness was observed when a bending load was applied transversely to a 3D printed layer. All timed tasks were successfully performed using a printed sponge stick, towel clamp, scalpel handle, and toothed forceps. There was no substantial difference in time to completion of simulated surgical tasks with control vs. 3D printed instruments. Of the surgeons, 100%, 92%, 85%, 77%, 77%, and 69% agreed that the printed smooth and tissue forceps, curved and straight hemostats, tissue and right angle clamps, respectively, would perform adequately. It is feasible to 3D print ABS thermoplastic surgical instruments on Earth. Loadbearing structures were designed to be thicker, when possible. Printing orientations were selected so that the printing layering direction of critical structures would not be transverse to bending loads.

On Demand Additive Manufacturing of a Basic Surgical Kit

On Demand Additive Manufacturing of a Basic Surgical Kit

Remanufacturing and Evaluation of Al Zahrawi’s Surgical instruments, Al Mokhdea as Scalpel Handle

Background: Current development of surgery is due to medical practitioners and surgeons practices and experiments throughout the history. Albucasis, the Muslim Spanish physician in 10 century AD was one of the pioneers in surgery that had major influence by his innovations in surgical techniques, treatment approaches and invention of instruments. He introduced a type of surgical knife named Mokhdea in his treaties, Al Tasreef that had mobile lancet. Material and Method: In this paper, we represent this historical instrument according to Albucasis points of view. Also, this knife was reproduced and finally a modified version of it was suggested for current using according to ancient knowledge. Results: Albucasis presented a retractable surgical knife with figure in the 30th volume of his book, Al Tasreef. According to his description, this instrument was made including blade, clamp and handle. Also, a standardized new scale up surgical knife was suggested. This instrument includes a blade united with a lever that moves throughout a rail in the handle. Conclusion: The idea of making retractable surgical knife dates back to about 1000 years ago; presented by Muslim physician, Albucasis. Also, new presented surgical knife is better compared with current knives because of its comfortable using, safety and scale up.

Use of double-bladed biopsy in distinguishing keratoacanthoma from squamous cell carcinoma-a case report

“The SCC Biopsy Tool” (name provided by current authors) is a double-bladed scalpel handle (manufactured and distributed by Surgidental Instruments, Deer Park, NY, USA) with two No. 11 scalpel blades (Swann-Morton, Sheffield, England) set in parallel, 1.5 mm apart (Figure 1). It provides an alternative to other partial biopsy methods and provides advantages over established techniques of shave and punch biopsy, particularly in differentiating squamous cell carcinoma (SCC) from keratoacanthoma (KA) on the leg and foot. The method of obtaining a full-thickness sample across the total width of a lesion with histologic sectioning in a longitudinal plane enables both architecture and cytology to be assessed accurately; precisely the requirement for distinguishing SCC from KA. The advantage over traditional incisional biopsy with a single blade is precision of parallel edges in a situation where central keratin provides an obstacle to such precision.

Intentional patina of metal archaeological artefacts: non-destructive investigation of Egyptian and Roman museum treasures

This paper describes microstructural analyses by X-ray portable diffraction and microdiffraction on intentional patina of the bronze museum objects from antique Egypt and the Roman Empire. They bring evidence of the presence in the true black bronze patinas of metallic gold and/or silver presumably as nanoparticles. Three other Egyptian patinas not belonging to black bronze are characterised. Apparent black patination on a Roman scalpel handle is discussed. The discovery of a new patination procedure on Roman artefacts from the Louvre museum is also related, based on intentional high temperature oxidation to obtain a dark patina on a lead bronze object. A presence of lead carbonate cerussite is an important observation.

Isolation of rat marrow-derived mesenchymal stem cells

Isolation of rat marrow-derived mesenchymal stem cells

Use of the trousseau dilator in cricothyrotomy

When performing cricothyrotomy, once the initial incision has been created, the scalpel handle may be inserted into the incision and rotated, or a Trousseau dilator may be used to widen the opening. During endotracheal (ET) tube passage, the Trousseau dilator may be left in place or a tracheal hook may be inserted for tracheal stabilization. This experimental crossover trial of cricothyrotomy in a cadaver model compared: 1) scalpel handle rotation to the use of a Trousseau dilator in widening the initial incision, and 2) the use of a tracheal hook to a Trousseau dilator during ET tube passage. Part 1: Cricothyrotomy incisions were made in 30 formalin-fixed cadavers using a #11 scalpel blade. The opening was initially widened using a Trousseau dilator or a scalpel handle rotated through 360°. Progressively larger ET tubes were passed using a tracheal hook for stabilization at the thyroid cartilage, and the size of the largest ET tube passed without significant resistance was recorded. Each opening was then widened using the other technique and ET tubes again passed as above. The dimensions of the opening after initial dilatation and after final ET tube passage were also recorded. Part 2: A tracheal hook inserted cephalad at the thyroid cartilage or a Trousseau dilator was used to stabilize the trachea during passage of progressively larger ET tubes, and the size of the largest ET tube passed without significant resistance was recorded. The insertion techniques were then reversed and ET tubes again passed as above. The trachea was inspected for damage and the balloon cuff checked for rupture after each attempt. Descriptive statistics were applied using a paired t-test and a chi-square analysis. We found no significant difference between the two techniques with regard to initial opening dimensions, final opening dimensions, or maximal ET tube size. There was no damage to local tissue and no balloon cuff ruptures. We found that the average size of the largest ET tube passed was significantly greater with the use of a tracheal hook (internal diameter mean 7.0 mm, median 7.0 mm) than with a Trousseau dilator (internal diameter mean 5.7 mm, median 5.5 mm). There was no damage to local tissue and no cuff ruptures. We conclude that the scalpel handle rotation technique is equal to the use of the Trousseau dilator with regard to opening size and maximal ET tube size but that use of a tracheal hook rather than a Trousseau dilator allows for passage of a larger ET tube in a cadaver model of cricothyrotomy.

Uniform Tissue Sections Cut with a Double-Bladed Scalpel

A double-bladed scalpel for cutting tissue sections of uniform thickness is described. A scalpel handle was modified to permit the insertion of adjacent parallel blades separated by a 3 mm gap. This instrument enhances the ability to cut tissue sections of a constant thickness before the samples are submitted for embedding. (The J Histotechnol 16:363, 1993)

A new scalpel handle for the cutaneous surgeon.

A newly designed scalpel handle that bridges the gap between a standard #3 and a Beaver handle is presented.

The Roman wreck ofc. AD 200 at Plemmirio, near Siracusa (Sicily): second interim report: The domestic assemblage 1: medical equipment and pottery lamps

A Roman wreck, Plemmirio B, lies in 22–47 m depth off the southern (Plemmirio) cliffs of Penisola della Maddalena, 5 km south of the Great Harbour (Porto Grande) of siracusa, Sicily (Figs 1, 2). The wreck was first seen in 1953, and was discovered anew by a University of Bristol expedition in 1974. Investigations at the site are now complete, after a programme of intensive survey and excavation by teams from the Universities of Bristol (1983) and Cambridge (1985, 1987). An interim report, based on work carried out to the end of the 1983 campaign, has been published (Gibbins & Parker, 1986); the present paper is the first of several reports to contain interim discussion of results from the 1985 and 1987 seasons. The Plemmirio B ship was transporting a small cargo of iron bars and North African cylindrical amphoras, and is a type-site for a group of 20 wrecks indicative of the first major phase of amphora export from Africa Proconsularis about the time of the Emperor Septimius Severus (AD 193–211). The first part of this paper contains a brief description of research objectives and methodology at Plemmirio, and a preliminary outline of 1985 and 1987 findings. Concentration in the second part is on two categories of artefacts among the assemblage of domestic objects from the ship's galley and living area. A unique discovery on an ancient wreck was a collection of medical equipment, probably part of a surgeon's instrumentarium; this material comprised two bronze scalpel handles with blunt dissectors, a bronze scalpel handle combined with an iron cautery or cataract needle (?), and a possible wooden ‘bandaging stick’. Four pottery lamps, one stamped on the base IVNDRA, an abbreviation of the maker's name, are also of exceptional interest. All are of a general form datable elsewhere to the Severan period; two can be provenanced to North Africa and two to central Tyrrhenian Italy, a pattern which is reflected in other domestic pottery from the wreck and is further evidence of the ship's movement between the ports of Africa Proconsularis and Rome[1].

A scalpel handle with electrocoagulating forceps

A scalpel handle with electrocoagulating forceps

Surgical gem. a new, rounded scalpel handle.

Surgical gem. a new, rounded scalpel handle.