A comparison of 1-port, 2-port, 3-port, and 4-port laparoscopic cholecystectomy techniques from the point of view of workflow criteria was made to both identify specific workflow components that can cause surgical disturbances and indicate good and bad practices. As a case study, laparoscopic cholecystectomies, including manual tasks and interactions within teamwork members, were video-recorded and analyzed on the basis of specially encoded workflow information. The parameters for comparison were defined as follows: surgery time, tool and hand activeness, operator's passive work, collisions, and operator interventions. It was found that 1-port cholecystectomy is the worst technique because of nonergonomic body position, technical complexity, organizational anomalies, and operational dynamism. The differences between laparoscopic techniques are closely linked to the costs of the medical procedures. Hence, knowledge about the surgical workflow can be used for both planning surgical procedures and balancing the expenses associated with surgery.
The outcomes proved that the surgical technique which is best for the patient imposes the greatest strain on the surgeon's wrist. .
Considering the negative consequences of stroke disease that dramatically reduce the quality of life of post-stroke patients and their families, it is urgent to offer more effective methods and tools for recovering the survivors in a possible short time. They must be accomplished in a way that preserves dignity and motivates the patient to relearn basic skills that the stroke disease may have impaired like bathing, eating, dressing and walking, shopping, speaking, reading and eventually return to working life. Taking this as a background for consideration, the aim of this paper is to present the research outcomes on the usefulness of the new and innovative rehabilitation pathways basing on Virtual Reality (VR) technologies. Basically, the case studies performed in the rehabilitation centre Technomex from Poland, encompassing the whole stroke patients' rehabilitation procedures with the use of VR were described. Simultaneously, these examples were the base for creating a comprehensive and professional training tool intended mostly for rehabilitators and physiotherapists about using VR technologies in supporting stroke survivors' recovery that is the main objective of the international project titled "Development of Innovative Training Contents Based on the Applicability of Virtual Reality in the Field of Stroke Rehabilitation", Brain4Train (contract number 2017-1-PL01-KA202-038370).
Introduction. This article is dedicated to the problematic of hazards that accompany surgeons during laparoscopic procedures, and may affected in excessive loads of certain segments of musculoskeletal system. Aim. The work focuses on new, in relation to the literature, methods for identifying hazards based on cross-sectional ergonomic analysis with the use of video recording and measurements of body position surgeon during the real surgical procedures. Material and methods. Research included three phases: diagnostic, simulation and fundamental. The aim of the diagnostic study was to determine the main problems in the field of body position ergonomics and the associated risks for the musculoskeletal system. Simulation study aimed at identifying the constraints and determining the conditions that are necessary in terms of making video recordings of real surgical procedures as well as real-time acquisition of measurement data defining postures surgeon. The aim of the fundamental study was to acquire basic knowledge about how to identify hazards for musculoskeletal of surgeons based on video recordings in real operational conditions, and to investigate the possibility of creating hazard maps in the field of musculoskeletal disorders. Results. There was identified relationships between the certain stressed body postures of surgeons and particular stage of the procedure as well as the type of surgical instruments. Conclusions. The synchronization of both video recordings of surgery and quantitative data identifying critical positions of the musculoskeletal system makes it possible to create hazard maps for surgeons and enables identification of the weak and strong points of the entire surgical procedure. This methodology may also reveal new knowledge in the work organization, workflow and ergonomics in surgery. S t r e s z c z e n i e Wstęp. Niniejszy artykuł poświęcony jest tematyce zagrożeń, jakie towarzyszą chirurgom podczas wykonywania zabiegów laparoskopowych i mogą ujawnić się nadmiernym obciążeniem określonych segmentów układu narządu ruchu. Cel pracy. W pracy skoncentrowano się na nowej, w stosunku do przeanalizowanych doniesień literaturowych, metodyce identyfikacji zagrożeń, opartej na przekrojowych analizach ergonomicznych, których podstawą jest zapis wideo i pomiary pozycji ciała chirurga podczas rzeczywistych zabiegów chirurgicznych. Materiał i metody. Badania naukowe obejmowały trzy fazy: diagnostyczną, symulacyjną i zasadniczą. Celem badań diagnostycznych było określenie głównych problemów w zakresie ergonomii pozycji ciała i związanych z nimi zagrożeń dla układu mięśniowo-szkieletowego. Badania symulacyjne miały na celu zidentyfikowanie ograniczeń i określenie warunków koniecznych w zakresie dokonywania rejestracji wideo rzeczywistych zabiegów chirurgicznych oraz akwizycji w czasie rzeczywistym danych pomiarowych określających pozycje ciała chirurga. Celem badań zasadniczych było pozyskanie wiedzy na temat możliwości identyfikacji zagrożeń dla układu narządu ruchu u chirurgów na podstawie zarejestrowany...
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