The effect of postural freedom to increase the neutral positions during laparoscopic surgery

Abstract

Laparoscopic technique has demonstrated numerous advantages compared to open conventional surgery. Nevertheless, this procedure increases the surgeons fatigue and thus, the potential to commit errors that may harm the patient during the operation. The post-surgery pain is also augmented because the surgeons are forced to adopt non-neutral postures during the practice. This study reveals how a Postural Freedom element could help surgeons to improve the postural hygiene. During this study, thirteen participants with and without previous experience in laparoscopic surgery performed a test with two instruments: a prototype that implement this postural freedom concept and a conventional fixed instrument. The results obtained indicate that the postural freedom element allows the participants to maintain neutral positions during greatest part of the experiment and suggest that the implementation of an articulated element could increases the neutral positions adopted during a real laparoscopic procedure. The use of the postural freedom concept allowed to the participants to reduce the awkward positions during upper limb motions and to reduce displacements, avoiding extreme abductions that are common with the conventional fixed instruments.

A Surface Electromyogram Evaluation of the Postural Freedom Effects in Laparoscopic Surgery

“…Different studies already indicated the forced non-neutral positions as the main cause of musculoskeletal problems for laparoscopic surgeons [3], [4]. In our experiment, the results showed the control instrument highest activity in muscles trapezius and deltoid (Fig.…”

“…However, for surgeons, these procedures have some complications. MIS procedures require more effort, concentration, cause more mental stress than open procedures, and force surgeons to adopt non-neutral postures with phalanges, hands, wrists and arms [3], [4]. Poor H. M. Pace-Bedetti and A. Conejero Rodilla are with the Instituto de Diseño y Fabricación (IDF), Universitat Politècnica de València (UPV).…”

“…Camino de Vera, s/n, 46022, Valencia, Spain (corresponding autor by e-mail: jlmartinez@eln.upv.es, geprabo@ci2b.upv.es). ergonomic postures accelerate muscle fatigue and pain because, outside the neutral range, muscles require more energy to generate the same contractile force than in neutral positions [3]. This is the reason why MIS have been commonly associated with higher muscular fatigue, higher levels of discomfort, and higher risk of occupational cumulative trauma injury than open procedures [3], [4].…”