New Ergonomic Design Criteria for Handles of Laparoscopic Dissection Forceps
ABSTRACT The shape of laparoscopic instrument handles can cause physical discomfort. This problem may be ascribed to a lack of standards for instrument design. In this study, new ergonomic requirements for the design of laparoscopic dissection forceps were created. Three representative handles (a Karl Storz [click-line] scissors handle, an Access Plus scissors handle, and an Aesculap cylindrical handle) currently available on the market were evaluated according to the new list of ergonomic criteria.
The handles were subjectively (questionnaire) and objectively (video analyses) tested in order to find out whether the new requirements are valid for the evaluation and design of instrument handles.
The outcome of the subjective and objective tests matched the predictions by the new criteria list. New criteria were introduced (neutral wrist excursions), and existing general criteria were specified (e.g., a minimal contact area of 10 mm). Significant differences were found among the three handles. The Storz handle met 8 of the 10 requirements, the Access handle met 5, and the Aesculap handle met only 4.
The new list of ergonomic requirements is a valid tool to determine the ergonomic value of a handle for laparoscopic dissecting tasks. It gains its strength from its specialized character. Significant differences were found among the three tested handles. Cylindrical handles were inferior to scissors handles.
Full-textDOI: · Available from: Richard Goossens, Feb 04, 2015
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- "Additionally, studies with tasks performed in a surgical trainer have reported higher workloads for surgical residents (Brown- Clerk et al, 2011; McCrory et al., 2012). These conditions have even been linked to long term damage for the surgeon (Berguer et al., 1997; Berguer, 1998a; Berguer et al., 1998b; Berguer et al, 1999; Berguer et al., 2001a; Berguer et al., 2001b; Emam et al., 2001; Van Veelen et all, 2001; Arora et al., 2010). This discomfort is in part due to the instruments (Lowndes et al., 2014). "
ABSTRACT: With various minimally invasive approaches in the field of surgery and new techniques entering rapidly, it is important to evaluate the effectiveness of these different practices. Information about the impact on both patient and provider can be gained through research investigations. Since the workload placed on the surgeon may influence patient outcomes, this study measured levels of stress and fatigue for the surgeon participating in an NIH randomized control trial of single incision versus 4-port laparoscopic cholecystectomy. Through the administration of the SURG-TLX for 22 Single-Incision Laparoscopic Cholecystectomies and 24 4-port cholecystectomies, physical workload was the only measure statistically different between 4-port and SILC (P=0.028). There was a significant difference in the duration (P=0.029) based on the procedure that was completed. Mental stress was highly correlated to many of the variables in the Surg-TLX and duration, degree of difficulty, and complexity were all highly correlated. This research shows how the SILC procedure can cause more stress on the surgeon. When the situation is combined with longer surgeries, higher complexity, and a higher degree of difficulty, the patient outcomes may be at risk.10/2014; 58(1):1280-1284. DOI:10.1177/1541931214581267
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- "As the complaints grew, an increasing number of researchers have focused on ergonomic problems in the OR. In 2001–2003, van VMA et al. , , , , in the faculty of industrial design engineering at Delft University of Technology, gradually developed a series of guidelines for surgeons to reduce the risk of laparoscopic injury. Nevertheless, more and more cases of occupational injury among laparoscopic surgeons have been reported. "
ABSTRACT: The prolonged and frequent use of laparoscopic equipment raises ergonomic risks that may cause physical distress for surgeons. We aimed to assess the prevalence of urologic surgeons' physical distress associated with ergonomic problems in the operating room (OR) and their awareness of the ergonomic guidelines in China. A sample of 300 laparoscopic urologists in China was assessed using a questionnaire on demographic information, ergonomic issues in the OR, musculoskeletal symptoms, and awareness of the ergonomic guidelines for the OR. There were 241 survey respondents (86.7%) with valid questionnaires. Among the respondents, only 43.6% placed the operating table at pubic height during the actual operation. The majority of the respondents (63.5%) used only one monitor during the procedure. Only 29.9% placed the monitor below the eye level. More than half of the respondents (50.6%) preferred to use manual control instead of the foot pedal. Most of the respondents (95.0%) never used the body support. The respondents experienced discomfort in the following regions, in ascending order: leg (21.6%), hand (30.3%), wrist (32.8%), shoulder (33.6%), back (53.1%), and neck (58.1%). The respondents with over 250 total operations experienced less discomfort than those with less than 250 total operations. Most of the respondents (84.6%) were unaware of the ergonomic guidelines. However, almost all of the respondents (98.3%) regarded the ergonomic guidelines to be important in the OR. Most of the laparoscopic urologists were not aware of the ergonomic guidelines for the OR; hence, they have been suffering from varying degrees of physical discomfort caused by ergonomic issues. There is an urgent need for education regarding ergonomic guidelines in the OR for laparoscopic urologists in China.PLoS ONE 07/2013; 8(7):e70423. DOI:10.1371/journal.pone.0070423 · 3.23 Impact Factor
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- "Overall, physical ergonomic issues have been identified in the operating room environment: the operating room table height, width and adjustability (Albayrak et al., 2004; Kranenburg & Gossot, 2004; Matern & Koneczny, 2007; Van Veelen,, Jakimowicz, & Kazemier, 2004), OR lights and lighting (Kaya et al., 2008; Matern & Koneczny, 2007), floor space and layout of ORs (Albayrak et al., 2004; Decker & Bauer, 2003; Kaya et al., 2008; Koneczny, 2009; Kranenburg & Gossot, 2004), trip hazard from cables (Koneczny, 2009; Matern & Koneczny, 2007), and monitor placement (Albayrak et al., 2004; Berguer, 1999; Decker & Bauer, 2003; Kaya et al., 2008; Matern & Koneczny, 2007; Van Veelen et al., 2001); Lin et al., 2007;. There has also been work examining the tools provided in the OR, especially those for minimally invasive or laparoscopic surgery: instruments (Kaya et al., 2008; Matern, 2001; Nguyen et al., 2001; Sheikhzadeh et al., 2009; Trejo et al., 2006; Trejo et al., 2007; Van Veelen et al., 2001), instrument carts (Albayrak et al., 2004; Sheikhzadeh et al., 2009), and foot pedals (Kranenburg & Gossot, 2004; Van Veelen et al., 2001). In addition, work has continued on identifying and quantifying the negative effects experienced by surgical team members as a result of the postures adopted during procedures (Albayrak et al., 2007; Kranenburg & Gossot, 2004; Matern & Koneczny, 2007), which can result in pain or work related musculoskeletal disorders (Forst, Friedman, & Shapiro, 2006; Gerbrands, Albayrak, & Kazemier, 2004; Kaya et al., 2008; Koneczny, 2009; Nguyen et al., 2001; Park et al., 2010; Sheikhzadeh et al., 2009). "
ABSTRACT: Given the complexity of health care and the 'people' nature of healthcare work and delivery, STSA (Sociotechnical Systems Analysis) research is needed to address the numerous quality of care problems observed across the world. This paper describes open STSA research areas, including workload management, physical, cognitive and macroergonomic issues of medical devices and health information technologies, STSA in transitions of care, STSA of patient-centered care, risk management and patient safety management, resilience, and feedback loops between event detection, reporting and analysis and system redesign.07/2011; 1(1):145-160. DOI:10.1080/19488300.2011.619158