A compliant bone drill provides advantages over conventional straight drills, because it allows surgical access via a minimally invasive approach. Hydropower allows the transfer of pressurized water with a compliant hose. The goal is to select the hydraulic actuator for this compliant bone drill by reviewing existing actuator principles. The selection was performed with a theoretical analysis. Design requirements were derived from a challenging minimally invasive bone drill procedure, and were set: a speed of 750 rpm, a torque of 0.015 Nm and a maximum dimensional volume of 5 mm × 5 mm × 10 mm to drill Ø 1.5 mm holes in human bone. A literature search was performed. For each actuator, the fluid flow and the required pressure difference were described as a function of the actuator dimensions and the rotational speed. Selection of the actuator was performed by it meeting the set output power, the torque, realistic input dimensions, and requiring the lowest pressure and number of parts. Existing literature provided six hydraulic actuators: external gear motor, gear ring motor, axial turbine, radial turbine, Pelton wheel, and Ossberger turbine. The latter four are hydrodynamic turbines, which could not meet the rotational speed. The external gear motor was selected for its lowest required pressure difference (11.5×105 Pa) and design simplicity. This theoretical design approach can be used for other applications.@en

The goal of this study was to determine the preferred handle design for two degrees of freedom steerable arthroscopic cutter by performing a two-step development approach. The expected usefulness and usability of control components of three entirely different handles were defined by an on-line survey with 101 students and the actual control by a standardised laboratory study with mock-up models by 16 students. The preferred handle design was integrated in a full functional prototype and optimized by 10 experts performing a meniscectomy on human cadaver knees. Students (survey 70% and task 91%) expected the same control behaviour as the experts (60%): steering a wheel to the right should evoke tip steering to the right regardless the orientation of the beak and moving a ring lever towards the handle’s centre point should evoke closure of the tip. Development of surgical instruments can benefit from expected control behavior based on daily life tools, but requires expert involvement for specific surgical tasks and context.

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