Laparoscopic scissors: A subjective and objective comparison of three brands

Background and Purpose: During laparoscopic surgery, scissors are used to cut a variety of tissue, including fibrotic or calcified tissue, sutures, and occasionally tissue containing staples. Disposable scissors may become dull and ineffective. The purpose of this study is to compare the durability and ergonomics of three different brands of laparoscopic scissors. Materials and Methods: Three different laparoscopic scissors (Applied Medical Direct Drive, Ethicon Endosurgery Endopath, U.S. Surgical Auto Suture Endo Shear) were used in this study. Six of each type were compared in a variety of objective and subjective tests. Subjective testing included two surgeons' ratings of the scissors' ability to cut fresh tissue and tissue with staples. Twenty blinded volunteers also rated the cutting ability and ergonomics of the scissors. Objective data included high-resolution digital photography and scanning electron microscopy of the scissor blades to quantify the number of imperfections after use. Results: All three new scissors easily cut fresh tissue. The Direct Drive performed significantly better when cutting staples, when cutting tissues after cutting staples, and in the combined overall comparison. Volunteers rated the cutting ability and ergonomics of the Direct Drive more desirable than the other brands. Further, high-resolution digital photography and scanning electron microscopy demonstrated significantly less damage to the Direct Drive. Finally, a reusable handle on the Direct Drive scissor resulted in a 53% and 59% cost savings compared with the Endopath and Endo Shear, respectively. Conclusions: All three types of scissors cut fresh tissue easily. The Direct Drive was significantly more durable, had better ergonomics, and was less expensive compared with the other two brands. © Copyright 2009, Mary Ann Liebert, Inc. 2009.