{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:57:42Z","timestamp":1784001462452,"version":"3.55.0"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T00:00:00Z","timestamp":1674950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&amp;D Program of China","doi-asserted-by":"publisher","award":["2021YFF0900600"],"award-info":[{"award-number":["2021YFF0900600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Laparoscopic surgery (LS) has been shown to provide great benefits to patients compared with open surgery. However, surgeons experience discomfort, low-efficiency, and even musculoskeletal disorders (MSDs) because of the poor ergonomic design of laparoscopic instruments. A methodology for the ergonomic design of laparoscopic dissector handles considering three-dimensional (3D) hand anthropometry and dynamic hand positions was addressed in this research. Two types of hand positions for grasping and stretching were scanned from 21 volunteers using a high-resolution 3D scanner. The 3D anthropometric data were extracted from these 3D hand pose models and used to design an improved handle (IH) that provides additional support for the thumb, a better fit to the purlicue, and a more flexible grasp for the index finger. Thirty subjects were invited to evaluate the IH in terms of muscular effort, goniometric study of motion, and efficiency and effectiveness during four trials of a laparoscopic training task. Questionnaires provided subjective parameters for ergonomic assessment. Positive results included less muscle load in the trapezius as well as significant but small angular differences in the upper limb. No significant reduction in the trial time and no increased percentage of the achievement were observed between the IH and the commercial handle (CH). Improved intuitiveness, comfort, precision, stability, and overall satisfaction were reported. IH provides significant ergonomic advantages in laparoscopic training tasks, demonstrating that the proposed methodology based on 3D anthropometry is a powerful tool for the handle design of laparoscopic dissectors and other surgical instruments.<\/jats:p>","DOI":"10.3390\/ijerph20032361","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T03:56:27Z","timestamp":1675050987000},"page":"2361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ergonomic Design and Assessment of an Improved Handle for a Laparoscopic Dissector Based on 3D Anthropometry"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-1637","authenticated-orcid":false,"given":"Yujia","family":"Du","sequence":"first","affiliation":[{"name":"School of Design, Hunan University, Changsha 410082, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2667-5722","authenticated-orcid":false,"given":"Rui","family":"Jiang","sequence":"additional","affiliation":[{"name":"School of Design, Hunan University, Changsha 410082, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9698-3790","authenticated-orcid":false,"given":"Haining","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Design, Hunan University, Changsha 410082, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/PL00009635","article-title":"Ergonomic problems associated with laparoscopic surgery","volume":"13","author":"Berguer","year":"1999","journal-title":"Surg. Endosc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/S0002-9610(01)00801-7","article-title":"An ergonomic evaluation of surgeons\u2019 axial skeletal and upper extremity movements during laparoscopic and open surgery","volume":"182","author":"Nguyen","year":"2001","journal-title":"Am. J. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s00464-001-8151-5","article-title":"Assessment of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery","volume":"16","author":"Uhrich","year":"2002","journal-title":"Surg. Endosc."},{"key":"ref_4","first-page":"143","article-title":"Hospital stay and return to full activity following laparoscopic colorectal surgery","volume":"12","author":"Raymond","year":"2008","journal-title":"JSLS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jss.2013.12.021","article-title":"Design and evaluation of a new ergonomic handle for instruments in minimally invasive surgery","volume":"188","author":"Sancibrian","year":"2014","journal-title":"J. Surg. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"103161","DOI":"10.1016\/j.apergo.2020.103161","article-title":"Ergonomic assessment of a new hand tool design for laparoscopic surgery based on surgeons\u2019 muscular activity","volume":"88","author":"Salgado","year":"2020","journal-title":"Appl. Ergon."},{"key":"ref_7","first-page":"242","article-title":"An Ergonomic Handle Design for Instruments in Laparoscopic Surgery","volume":"10","author":"Sancibrian","year":"2016","journal-title":"Int. J. Biol. Biomed. Eng."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1108\/RPJ-06-2019-0157","article-title":"Individual customization strategy accomplished by developing prototype of a laparoscopic forceps handle using additive manufacturing","volume":"26","author":"Sreekanth","year":"2020","journal-title":"Rapid Prototyp. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.ijsu.2016.04.027","article-title":"Building a framework for ergonomic research on laparoscopic instrument handles","volume":"30","author":"Li","year":"2016","journal-title":"Int. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1001\/archsurg.1993.01420220092016","article-title":"Laparoscopic surgeon\u2019s thumb","volume":"128","author":"Kano","year":"1993","journal-title":"Arch. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3109\/13645709709152823","article-title":"Neuropraxia following laparoscopic procedures: An occupational injury","volume":"6","author":"Horgan","year":"1997","journal-title":"Minim. Invasive Ther. Allied Technol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s004649900316","article-title":"A comparison of surgeons\u2019 posture during laparoscopic and open surgical procedures","volume":"11","author":"Berguer","year":"1997","journal-title":"Surg. Endosc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1001\/archsurg.138.9.967","article-title":"A comparison of the physical effort required for laparoscopic and open surgical techniques","volume":"138","author":"Berguer","year":"2003","journal-title":"Arch. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.ygyno.2014.05.019","article-title":"Physician pain and discomfort during minimally invasive gynecologic cancer surgery","volume":"134","author":"McDonald","year":"2014","journal-title":"Gynecol. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1007\/s00464-016-5020-9","article-title":"Musculoskeletal pain among surgeons performing minimally invasive surgery: A systematic review","volume":"31","author":"Dalager","year":"2017","journal-title":"Surg. Endosc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s004640090102","article-title":"Improved usability of a new handle design for laparoscopic dissection forceps","volume":"16","author":"Veelen","year":"2002","journal-title":"Surg. Endosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1089\/lap.1999.9.481","article-title":"Ergonomics and design of laparoscopic instruments: Results of a survey among laparoscopic surgeons","volume":"9","author":"Meijer","year":"1999","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1080\/001401399184721","article-title":"A comparison of forearm and thumb muscle electromyographic responses to the use of laparoscopic instruments with either a finger grasp or a palm grasp","volume":"42","author":"Berguer","year":"1999","journal-title":"Ergonomics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4669","DOI":"10.3233\/WOR-2012-0107-4669","article-title":"Disparities between industrial and surgical ergonomics","volume":"41","author":"Seagull","year":"2012","journal-title":"Work"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jamcollsurg.2009.10.017","article-title":"Patients benefit while surgeons suffer: An impending epidemic","volume":"210","author":"Park","year":"2010","journal-title":"J. Am. Coll. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.apergo.2018.11.010","article-title":"A novel anatomical woodworking chisel handle","volume":"76","author":"Bisht","year":"2019","journal-title":"Appl. Ergon."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1080\/00140139.2015.1075603","article-title":"Ergonomic design and evaluation of the handle for an endoscopic dissector","volume":"59","author":"Shimomura","year":"2016","journal-title":"Ergonomics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"103210","DOI":"10.1016\/j.apergo.2020.103210","article-title":"Ergonomic evaluation and performance of a new handle for laparoscopic tools in surgery","volume":"89","author":"Sancibrian","year":"2020","journal-title":"Appl. Ergon."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ergon.2015.03.007","article-title":"Optimisation of a laparoscopic tool handle dimension based on ergonomic analysis","volume":"48","author":"Gonzalez","year":"2015","journal-title":"Int. J. Ind. Ergon."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez, A.G.l., Salgado, D.R.g., Moruno, L.G.a., and R\u00edos, A.S.n. (2018). An Ergonomic Customized-Tool Handle Design for Precision Tools using Additive Manufacturing: A Case Study. Appl. Sci., 8.","DOI":"10.3390\/app8071200"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Margallo, J.A., Gonz\u00e1lez, A.G.L., Moruno, L.G.A., G\u00f3mez-Blanco, J.C., Pagador, J.B., and S\u00e1nchez-Margallo, F.M. (2020). Comparative Study of the Use of Different Sizes of an Ergonomic Instrument Handle for Laparoscopic Surgery. Appl. Sci., 10.","DOI":"10.3390\/app10041526"},{"key":"ref_27","unstructured":"Griffin, L., Kim, N., Carufel, R., Sokolowski, S., Lee, H., and Seifert, E. (2018). International Conference on Applied Human Factors and Ergonomics, Springer."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.apergo.2017.05.014","article-title":"The Dibber: Designing a standardised handheld tool for lay-up tasks","volume":"65","author":"Jones","year":"2017","journal-title":"Appl. Ergon."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1108\/ir.1998.25.2.153.2","article-title":"Human factors in engineering and design","volume":"25","author":"Sanders","year":"1998","journal-title":"Ind. Robot"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1007\/BF00187956","article-title":"Digital nerve compression due to laparoscopic surgery","volume":"9","author":"Bax","year":"1995","journal-title":"Surg. Endosc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1410996","DOI":"10.1080\/23311916.2017.1410996","article-title":"Design and stepwise user evaluation of an ergonomic 2 DOF arthroscopic cutter","volume":"4","author":"Horeman","year":"2017","journal-title":"Cogent Eng."},{"key":"ref_32","unstructured":"Pokorny, C., Juhnke, B., and Griffin, L. (2020). AHFE, Springer."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Griffin, L., Sokolowski, S.L., and Seifert, E. (2018, January 6\u201317). Process Considerations in 3D Hand Anthropometric Data Collection. Proceedings of the 9th International Conference and Exhibition on 3D Body Scanning and Processing Technologies, Lugano, Switzerland.","DOI":"10.15221\/18.123"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.apergo.2012.10.001","article-title":"2D and 3D anatomical analyses of hand dimensions for custom-made gloves","volume":"44","author":"Yu","year":"2013","journal-title":"Appl. Ergon."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/10400435.2019.1709917","article-title":"Customized designs of short thumb orthoses using 3D hand parametric models","volume":"34","author":"Chu","year":"2022","journal-title":"Assist. Technol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.proeng.2015.12.590","article-title":"Guide design of precision tool handle based on ergonomics criteria using parametric CAD software","volume":"132","author":"Salgado","year":"2015","journal-title":"Procedia Eng."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s004649900934","article-title":"Instruments for minimally invasive surgery","volume":"13","author":"Matern","year":"1999","journal-title":"Surg. Endosc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00464-015-4164-3","article-title":"Effect of a laparoscopic instrument with rotatable handle piece on biomechanical stress during laparoscopic procedures","volume":"30","author":"Steinhilber","year":"2016","journal-title":"Surg. Endosc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/LBR.0000000000000615","article-title":"Assessment of Ergonomic Strain and Positioning during Bronchoscopic Procedures: A Feasibility Study","volume":"27","author":"Gilbert","year":"2020","journal-title":"J. Bronchol. Interv. Pulmonol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1007\/s00464-009-0714-x","article-title":"Ergonomics of disposable handles for minimally invasive surgery","volume":"24","author":"Buchel","year":"2010","journal-title":"Surg. Endosc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1007\/s00464-014-4005-9","article-title":"The effect of ergonomic laparoscopic tool handle design on performance and efficiency","volume":"29","author":"Tung","year":"2015","journal-title":"Surg. Endosc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1089\/10926420150502896","article-title":"New ergonomic design criteria for handles of laparoscopic dissection forceps","volume":"11","author":"Meijer","year":"2001","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s004649901093","article-title":"MIS instruments","volume":"13","author":"Matern","year":"1999","journal-title":"Surg. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/0003-6870(93)90006-U","article-title":"Sensitivity of the hand to surface pressure","volume":"24","author":"Kilbom","year":"1993","journal-title":"Appl. Ergon."},{"key":"ref_45","unstructured":"Delleman, N., Boocock, M., Kapitaniak, B., Schaefer, P., and Schaub, K. (2020). Human Factors and Ergonomics Society Annual Meeting, SAGE Publications SAGE CA."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/136457001753192295","article-title":"Principles of ergonomic instrument handles","volume":"10","author":"Matern","year":"2001","journal-title":"Minim. Invasive Ther. Allied Technol."},{"key":"ref_47","unstructured":"(2008). Single-Use Medical Examination Gloves\u2014Part 1: Specification for Gloves Made from Rubber Latex or Rubber Solution (Standard No. ISO 11193-1)."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"103045","DOI":"10.1016\/j.apergo.2020.103045","article-title":"Development of an ergonomic four-finger-push manual pipette design","volume":"85","author":"Kim","year":"2020","journal-title":"Appl. Ergon."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0003-6870(99)00039-3","article-title":"Rapid Entire Body Assessment (REBA)","volume":"31","author":"SueHignett","year":"2000","journal-title":"Appl. Ergon."},{"key":"ref_50","unstructured":"(2009). Ergonomics-Manual Handling-Part 3: Handling of Low Loads at High Frequency (Standard No. ISO 11228-3)."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s004649900705","article-title":"Surgical technology and the ergonomics of laparoscopic instruments","volume":"12","author":"Berguer","year":"1998","journal-title":"Surg. Endosc."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1007\/s00464-013-3334-4","article-title":"Objective analysis of surgeons\u2019 ergonomy during laparoendoscopic single-site surgery through the use of surface electromyography and a motion capture data glove","volume":"28","year":"2014","journal-title":"Surg. Endosc."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/2361\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:18:45Z","timestamp":1760120325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/2361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,29]]},"references-count":52,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20032361"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20032361","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,29]]}}}