Optimal Design of the Laparoscopic Grasper Mechanism with Low Friction and Backlash

Round 1

Reviewer 1 Report

The article is a relevant subject but written at a low level. 

There are a lot of points that need to be corrected, so I recommend a rejection of the article.

 

The title of the article completely corresponds to it.

The article has a few points that need to be corrected:

• There are many self-citations (18-30) that are not related to the research being cited. The literature review should be expanded.

• In general, the introduction looks clumsy, it feels like it was made from different pieces of text. Special attention is given to the omitted thought after (15), the inserted text and the jump to (18).

• The authors of the article in the conclusions to the article say that "The main purpose of this paper is to show possibilities for optimization of the laparoscopic grasper mechanism designed". However, such a statement should be given in the introduction, and the results obtained should be given in the conclusions. In addition, writing an article to show the possibility for optimization does not sound scientific (optimization is either carried out or not carried out).

• It is not clear how the authors conclude that their design is better than [6–8]. Some of the figures are redrawn from these publications. In addition, in line 66, the authors indicate that the presented constructions prevent accurate grasping. Where did the authors get this data? How much has the optimization of the design affected the accuracy of the mechanism compared to previous versions?

• In the introduction, the authors need to fully justify the novelty and relevance of the work. Now it is difficult to call it a justification.

• Section 5 is poorly structured and needs to be completely redone. The authors should present the results of the already existing designs and compare them with the optimized one. That will allow to assess the contribution of optimization of the mechanism.

• The obtained results are not analyzed. The authors provide many figures 7-10 and one sentence about them. All the obtained results should be substantiated and compared with each other, which will allow to see the advantages and disadvantages of the proposed optimization of the mechanism.

• In the conclusion, line 416, the authors indicate "These results are very good compared with many other grasper mechanisms.". Not a scientific statement at all, which has no basis, since no analysis was conducted. With what construction did the authors compare the results? How much better are they than other designs? The authors introduce a subjective opinion into the conclusions, which is unacceptable.

• The second paragraph with the conclusion should go first, without specifying references.

Author Response

Reviewer 1:
Dear reviewer, thank you for your critical comments. They have helped me to reflect on the
shortcomings of the original work and to try to improve it.
‒ In the Abstract, the last seven rows are changed. Information on the results of the paper
has been extended.
‒ Chapter 1. Introduction is substantially enriched with additional literature, mainly in the
field of compliant mechanisms of laparoscopic instruments and also in the field of
laparoscopic instruments with electronic feedback systems. The number of papers
describing the work of the main author of the paper in the field of optimization of
mechanical and mechatronic systems has been reduced. The novelty of the paper has
been better described.
‒ On page 9 equation (16) has been corrected ‒ dividing by N.
‒ It is practically impossible to compare the laparoscopic grasper addressed in this paper
with many other papers because they do not provide data on the force transmission
between the input and the output. However, as far as the mechanical graspers presented in
the work of J. L. Herder et al. are concerned, these have an ideal force transmission. This
information has been added in the paper (in Introduction and also in Conclusions).
‒ A new chapter 6. Methods of solution of the optimization problem has been added.
‒ Chapter 7. Results of optimization and discussion have been substantially extended. The
number of figures has been reduced, all figures and presented results are now described.
‒ Chapter 8. Conclusions has been corrected according to reviewer's requirements and
extended.

Reviewer 2 Report

The manuscript entitled “Optimal Design of the Laparoscopic Grasper Mechanism with Low Friction and Backlash” is well-written and well-structured. The topic addressed is of undisputed topicality and importance both in human surgical practice and also in veterinary medicine. In light of the increasing use of this surgical technique, in fact, it is necessary to extend research to the realization of instrumentation and techniques that make the surgeon's sensitivity, which remains to all intents and purposes the most limiting issue of the laparoscopic technique, ever greater.

The Authors concisely but more than sufficiently and clearly introduce the issue taking care to detail and explain especially to extremely rigorous diagrams the physics of the instrument.

Ultimately, I do not find any aspects that need to be changed in the manuscript, which I therefore believe can be published without further correction. I take this opportunity to congratulate the Authors on their work.

Author Response

Dear reviewer, thank you for your encouraging remarks.

Reviewer 3 Report

The authors conducted a study to investigate the means of improving the tactile sensation of surgeons during laparoscopy by decreasing fraction and almost isolating the forces generated on the surgeons’ hands to be those only generated from the tissue-grasper interaction. I found this paper interesting and could have further industrial implications. I agree that the decreased sensation of the body tissues is a drawback of laparoscopic surgery where this  could be really important to decide whether more dissection is necessary or not. I cannot judge the methodology because I am a doctor but I can guarantee that the medical implications are sound and accurate. I would only suggest minor language polishing to further improve the context.

Author Response

Rewiever 3:
Dear reviewer, thank you for your encouraging remarks. In cooperation with my English speaking
colleague, I tried to do a language polishing of the text of the paper.
For example:
‒ On page 6, when defining the parameters  ,  , ..., 1  , the definite articles „the“ are
omitted.
‒ On page 9 there are modifications to the section headings:
‒ 5.1 Constraints of the optimization problem (instead of task)
‒ 5.2 Variables of the optimization problem (instead of task)
‒ On pages 9, 10 when defining the parameters 2 2 , r , , ..., dc, cc, the definite articles „the“
are omitted.
‒ On page 10 in the definition of Specified variables, the definite articles „the“ are omitted.
Some corrections of minor importance are not mentioned here.

Reviewer 4 Report

This article name of "Optimal Design of the Laparoscopic Grasper Mechanism with Low Friction and Backlash" has planned a new laparoscopic grasper design for better results for grasper forces, tissue tactile feel and movement.

It would be more appropriate for this article to be evaluated by an expert whose main profession is engineering.

Author Response

Reviewer 4:
Dear reviewer, thank you for your brief comments on the focus of the paper and for the recommendation that the paper be reviewed by an expert whose main profession is engineering.

Round 2

Reviewer 1 Report

The authors have significantly improved the article. Removed links to irrelevant works and improved overview.

However, the authors need to present a comparison of the previous design and the optimized one. The presented graphs should show the results of the gripper before and after optimization. This will make it possible to make a conclusion about the optimization of certain parameters. Without presenting such results, the authors cannot talk about optimization, as it is not confirmed by anything.

Author Response

Rewiever 1:

 

Dear reviewer, thank you for your critical comments. They have helped me to reflect on the shortcomings of the original work and to try to improve it.

 

• In the Abstract, the last seven rows are changed. Information on the results of the paper has been extended.

 

• Chapter Introduction is substantially enriched with additional literature mainly in the field of compliant mechanisms of laparoscopic instruments and also in the field of laparoscopic instruments with electronic feedback systems. The number of papers describing the work of the main author of the paper in the field of optimization of mechanical and mechatronic systems has been reduced. The novelty of the paper has been better described.

 

• On page 9 equation (16) has been corrected ‒ dividing by N. The objective function is now the root mean square of the differences between the force acting on the handle and the grasping force .

 

• It is practically impossible to compare the laparoscopic grasper addressed in this paper with many other papers because they do not provide data on the force transmission between the input and the output. However, as far as the mechanical graspers presented in the work of J. L. Herder et al. are concerned, these have an ideal force transmission. This information has been added in the paper (in Introduction and also in Conclusions).

 

• A new chapter Methods of solution of the optimization problem has been added. This chapter briefly describes two main methods used in this work: 1/ a deterministic method based on sequential quadratic programming, 2/ a stochastic method based on genetic algorithms.

 

• Chapter Results of optimization and discussion have been substantially extended. The number of figures has been reduced, all figures and presented results are now described.

 

• Chapter Conclusions has been corrected according to reviewer's requirements and extended.

 

• Added literature is highlighted in yellow in the References.

Author Response File: Author Response.pdf