Armour: Upper Limb Support System for Laparoscopic Procedures

Proper arm positioning during laparoscopic procedures is critical for patient safety. Each year, there are 7.5 million laparoscopic procedures conducted worldwide. Positioning injuries account for 4% of the medical errors in the medical world. The Trendelenburg position involves elevating the patient’s lower extremities above the head, while lying supine. This position, commonly used in obstetrics and gynecology, can exert increased pressure on the upper extremities, leading to distal neuropathy. Clinicians address the problem with an arm-tuck procedure that aligns the upper extremities in neutral position to reduce the risk of pressure-related injuries. They utilize spare materials found in the operating room, including: egg crate foam, gel pads, towels, tape and bed sheets. The arm-tuck procedure leads to OR delay, is labor intensive to clinicians and is non-standardized. At our institution, it required over nine minutes for three people to implement the current arm-tuck procedure for two patient arms. Our proposed solution consists of a rigid arm support that is lined with a casted polymer, and is adjustable to patient size with translational movement via rails attached to the base. The device attaches to the operating table via a metal post inserted into a Clark socket clamp. The arm support system is made from medical grade materials, such as castable silicone polymer, sterilizable vinyl and surgical gel pads. The proposed device is a Class II device. We compared the set up time required for both the arm-tuck procedure and proposed solution. Any trial that takes less than five minutes for both arms to setup is a success. Survey feedback was provided to help revise the prototype. This project evolved from a validated clinical need through participation in the Clinical Immersion Program, under the mentorship of Dr. Ramanathan.