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Manipulating rigid instruments through these constrained spaces makes this approach technically challenging, and thus, a handheld robotic instrument could expand the surgeon\u2019s capabilities. In this study, we present an intuitive handle prototype for such a robotic instrument.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>\n                           <jats:bold>Methods<\/jats:bold>\n                        <\/jats:title>\n                <jats:p>We have designed and fabricated a surgical instrument handle prototype that maps the surgeon\u2019s wrist directly to the robot joints. To alleviate the surgeon\u2019s wrist of any excessive strain and fatigue, the tool is mounted on the surgeon\u2019s forearm, making it parallel with the instrument\u2019s shaft. To evaluate the handle\u2019s performance and limitations, we constructed a surgical task simulator and compared our novel handle with a standard neurosurgical tool, with the tasks being performed by a consultant neurosurgeon.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>\n                           <jats:bold>Results<\/jats:bold>\n                        <\/jats:title>\n                <jats:p>While using the proposed handle, the surgeon\u2019s average success rate was <jats:inline-formula><jats:alternatives><jats:tex-math>$$80\\%$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mrow>\n                      <mml:mn>80<\/mml:mn>\n                      <mml:mo>%<\/mml:mo>\n                    <\/mml:mrow>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>, compared to <jats:inline-formula><jats:alternatives><jats:tex-math>$$41\\%$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mrow>\n                      <mml:mn>41<\/mml:mn>\n                      <mml:mo>%<\/mml:mo>\n                    <\/mml:mrow>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula> when using a conventional tool. Additionally, the surgeon\u2019s body posture while using the suggested prototype was deemed acceptable by the Rapid Upper Limb Assessment ergonomic survey, while early results indicate the absence of a learning curve.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>\n                           <jats:bold>Conclusions<\/jats:bold>\n                        <\/jats:title>\n                <jats:p>Based on these preliminary results, the proposed handle prototype could offer an improvement over current neurosurgical tools and procedural ergonomics. By redirecting forces applied during the procedure to the forearm of the surgeon, and allowing for intuitive surgeon wrist to robot-joints movement mapping without compromising the robotic end effector\u2019s expanded workspace, we believe that this handle could prove a substantial step toward improved neurosurgical instrumentation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11548-021-02402-4","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T10:02:43Z","timestamp":1621850563000},"page":"1131-1139","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["An intuitive surgical handle design for robotic neurosurgery"],"prefix":"10.1007","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-8034","authenticated-orcid":false,"given":"Emmanouil","family":"Dimitrakakis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Lindenroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Dwyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Aylmore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil L.","family":"Dorward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani J.","family":"Marcus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danail","family":"Stoyanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"issue":"7","key":"2402_CR1","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1586\/17434440.2016.1146585","volume":"13","author":"PL Anderson","year":"2016","unstructured":"Anderson PL, Lathrop RA, Webster RJ III (2016) Robot-like dexterity without computers and motors: a review of hand-held laparoscopic instruments with wrist-like tip articulation. 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