. Author manuscript; available in PMC: 2018 Dec 10.

Published in final edited form as: World J Surg. 2017 Jan;41(1):314–319. doi: 10.1007/s00268-016-3814-5

Table 1.

Description of design modifications resulting from each iterative cycle.

Iterative Cycle	Iteration Type	Army Navy	Scalpel Handel	Forceps	Hemostats	Needle Driver
1	Simulated	Ribs added along length for strength	Multiple designs created	Finger grips added	Locking teeth refined	Tips adjusted for better approximation
2	Surgical	None	Fully reinforced model chosen	Cross hatched surface added to tips	Hinge modified to ↓ tip crossing	Hinge modified to ↓ tip crossing
3	Simulated	None	None	Resting position of arms widened	Handel adjusted for ↑ ergonomics	Total redesign
4	Surgical	Retractor blades strengthened	None	↑ Thickness and resistance of arms	Arms	Handel hole diameter increased
5	Simulated	None	None	None	Tips strengthened	None