Innovative instruments

[caption id="attachment_7673" align="alignnone" width="325"] David R Chow MD[/caption] Customised retinal forceps grips created with three-dimensional (3D) printing will bring surgeons personalised handheld instrumentation that should translate into better ergonomics and comfort, said David R Chow MD at the 16th EURETINA Congress in Copenhagen, Denmark. “During the history of retinal surgery, we have been using forceps with a standard design that does not take into account human variation in the size and shape of hands and grips. No doubt surgeons are doing a great job using the available instruments, but I believe we could do better with customisation. 3D printing is changing the manufacturing process and allows customised instrumentation to be created without major production costs,” said Dr Chow, Assistant Professor of Ophthalmology, University of Toronto, Canada. Dr Chow is working in conjunction with Katalyst Surgical to bring his idea to market. After testing forceps moulds of different sizes and different materials to create a suitable model, Dr Chow imprinted his grip at the desired depth. The impression is scanned using a 3D scanner to create a software file for superimposing the grip onto the forceps that is done using selective laser sintering. Simultaneously, Dr Chow and colleagues worked to identify the ideal substrate forceps. To validate the idea that, when given the choice, surgeons would prefer different grip designs, Dr Chow sought the cooperation of four prominent retinal surgeons from around the world. The group was comprised of male and female surgeons, with varying heights, in order to recruit individuals with different hand types. Each surgeon was provided with different moulds from which he or she could choose a preferred mould size and then the preferred depth of the imprint created with their grip. “It was striking to see the significant differences in the four prototype forceps that were created when just four surgeons were given the opportunity to personalise the grip,” Dr Chow said, adding that additional data were being collected from a larger group of 80 surgeons. Next, new prototypes that would allow rotation of tips with the customised grips were developed and validated. Looking ahead, Dr Chow said he also has ideas for creating other customised instruments using 3D printing. Proof that grip personalisation improves surgeon performance may be difficult to obtain. The issue is being explored, however, by reviewing intraoperative videos of surgeons completing different manoeuvres using standard and customised forceps. Nevertheless, considering his experience with ski boots as an analogous situation, Dr Chow is convinced the customisation will deliver a comfort advantage. “I cannot say for sure that I ski better when wearing my moulded boots versus a rental pair, but I know that when I am wearing the personalised product, I feel much better and am much happier at the end of the day,” he said. David R Chow: davidrchow@me.com

Tags: 3D, retina