Ergonomic problems associated with laparoscopic surgery

Berguer, Ramón; Forkey, D L; Smith, Warren D.

doi:10.1007/pl00009635

Cited by 322 publications

(253 citation statements)

References 9 publications

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“…More detailed guidelines for different variables in the operating room are stated concerning the table height [4,9,11,16], the monitor placement [8,9,13,[15][16][17], the instrument's handle design [1,3,5,10,16], the foot pedals [20], and the physical discomfort of the operating team [2,10,12,18,19]. Still, the question is whether these guidelines are known and used.…”

Section: Introductionmentioning

confidence: 99%

Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

et al. 2006

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Background: This study aimed to obtain an answer for the question: Are ergonomic guidelines applied in the operating room and what are the consequences? Methods: A total of 1,292 questionnaires were sent by email or handed out to surgeons and residents. The subjects worked mainly in Europe, performing laparoscopic and/or thoracoscopic procedures within the digestive, thoracic, urologic, gynecologic, and pediatric disciplines. Results: In response, 22% of the questionnaires were returned. Overall, the respondents reported discomfort in the neck, shoulders, and back (almost 80%). There was not one specific cause for the physical discomfort. In addition, 89% of the 284 respondents were unaware of ergonomic guidelines, although 100% stated that they find ergonomics important. Conclusion:The lack of ergonomic guidelines awareness is a major problem that poses a tough position for ergonomics in the operating room.

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Section: Introductionmentioning

confidence: 99%

Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

et al. 2006

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“…A major part of this fatigue is due to the mental exertion required for intensive concentration during the laparoscopic procedure, where mental rotations and transformations play a demanding role. The cost of mental fatigue is not trivial; it can reduce the surgeon's decision-making ability and increase the potential for errors, thus affecting patient outcome [1,3,15,17].…”

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confidence: 99%

Reaction times and the decision-making process in endoscopic surgery

2003

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Background: There are times during endoscopic procedures when the displayed surgical field does not align with the actual field due to rotation of the camera. The surgeon's performance may deteriorate under this situation. However, the effects of misalignment on the decision-making processes during endoscopic procedures have not been fully explored. The present study addresses this problem and suggests a technique that may be used to alleviate it. Methods: Two experiments were completed in a mock endoscopic surgical setup where the image of the work plane inside the training box was either projected on a vertical monitor placed at eye level or superimposed over the training box by means of a half-silvered mirror. The work plane consisted of a start plate and four target plates. The experimenter varied the number of choices of target location among one, two, and four target choices. Rotating the camera about its longitudinal axis misaligned the displayed and the actual work plane. There were two experiments that differed in task difficulty. The task in experiment 1 was to touch the target plate, whereas the task in experiment 2 was to reach, grasp, and transport the object from the target to the start plate. Results: Experiment 1 showed that reaction time increased with the number of the choices for a touch task, in accordance with the Hick-Hyman law. Using a graspand-transport task, experiment 2 replicated experiment 1 and extended the results to show that the use of a superimposed image display facilitated the decisionmaking process, leading to shorter reaction times compared to the vertical image display. Discussion: During endoscopic procedures, the surgeon needs to translate indirect perceptions to instrumentmediated actions by ''mapping'' them through sensorimotor integration. The superimposed image alleviates the mental load of spatial transformations by reducing the difficulty of the required sensorimotor mapping. These findings have important implications for the design of high-quality superimposed display technologies.

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“…One criterion often analysed is the time to perform the procedure. Although the relevance of the procedures' time is unquestionable from an economic perspective, the analysis alone does not reflect surgical proficiency 10 . Complex laparoscopic tasks, such as laparoscopic sutures and intracorporeal knots, require a high level of technical skill.…”

Section: ■ Discussionmentioning

confidence: 99%

Abdominal cavity simulator for skill progression in videolaparoscopic sutures in Brazil

et al. 2018

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Purpose: To develop and test a model of teaching by means of an abdominal cavity simulator. Methods: This study had two stages: development of a teaching model and an experimental prospective study that aimed to evaluate the residents' competence. The participants were divided into 3 groups: first-year resident, second-year resident, and senior surgeon. The two groups of resident physicians received training in the simulator, under instructor supervision for skill acquisition, according to the model proposed in first stage. The surgeons did not receive this intervention. The correlations and associations were verified through simple and multiple linear regressions. The learning curves were analysed using Cox regression models. The impact of the epidemiological characteristics was tested. Results: All residents reached the maximum score at the end of 16 steps and were comparable to the experimental (p<0.001). Conclusion:Residents who underwent training using the methodology of the proposed teaching model, which is based on realistic simulation, acquired proficiency in the accomplishment of endosutures in up to 16 hours of training in the laboratory. IIPhD, Centro Universitário Unichristus, Fortaleza-CE, Brazil. Conception, design and intellectual content of the study; critical revision; approved the final version.

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Ergonomic problems associated with laparoscopic surgery

Abstract: These findings indicate that laparoscopic surgical technique is more taxing on the surgeon.

Cited by 322 publications

References 9 publications

Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

Reaction times and the decision-making process in endoscopic surgery

Abdominal cavity simulator for skill progression in videolaparoscopic sutures in Brazil

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