Previous studies have shown that the handle design of laparoscopic instruments is crucial to surgical performance and surgeon’s ergonomics. In this study, four different sizes of an ergonomic laparoscopic handle design were tested in a blind and randomized fashion with twelve surgeons. They performed three laparoscopic tasks in order to analyze the influence of handle size. Execution time, wrist posture, and finger and palm pressure were evaluated during the performance of each task. The results show a significant reduction in the time required to complete the eye-manual coordination task using the appropriate handle. The incorrectly sized handle resulted in a rise in palm pressure and a reduction in the force exerted by the thumb during the transfer task. In the hand-eye coordination task, the use of the right handle size led to an increase in middle finger pressure. In general, surgeons had an ergonomically adequate wrist flexion in all tasks and an acceptable radio-ulnar deviation during the transfer task using the ergonomic instrument handle. Surgeons found it comfortable the use of the ergonomic handle. Therefore, the use of an appropriately sized instrument handle allows surgeons to improve ergonomics and surgical performance during the laparoscopic practice.

The use of benchmarking in the management of healthcare facilities enables immediate comparison between hospitals. Benchmarking allows ascertaining their expected energy consumption and estimating the possible savings margin. In the 2005–2015 period, 90 EU Eco-Audits of 23 public hospitals in Germany were studied to analyze the energy consumption related with weather conditions, built surface area, gross domestic product (GDP), geographic location (GL), bed numbers, and employee numbers. The results reveal that the average annual energy consumption of a hospital under normal conditions, both climatic and operational, is 0.27 MWh/m2, 14.37 MWh/worker, and 23.41 MWh/bed. The indicator dependent on the number of beds proved to be the most suitable as a reference to quantify the energy consumption of a hospital.

No abstract

No abstract

A study was carried out with 135 surgeons to obtain a surgical laparoscopic grasper handle design that adapts to the size of each surgeon's hand, in a functionally appropriate way, and has the sufficient ergonomics to avoid generating the problems detected nowadays. The main conclusion of the work is the practical 3D parametric design obtained for a laparoscopic surgical graspers handle that is scalable to fit each particular surgeon's hand size. In addition, it has been possible to determine that the anthropometric measure of the surgeon's hand defined as Palm Length Measured (PLM) allows the design of the 3D parametric model of the surgical handle to be conveniently scaled. The results show that both additive manufacturing and the application of ergonomics criterion provide an efficient method for the custom design and manufacture of this type of specialised tool, with potential application in other sectors.

No abstract

A hospital's water installations are critical for its function, but the environmental cost is high. This study quantifies the mean potable cold water consumption (PCWC) in 19 hospitals belonging to the German Public Health System. The hospital floor area ranges from 3000 to 151,000 m 2 and the number of beds from 45 to 1003 beds. To this end, 60 Eco-Management and Audit Scheme statements were analyzed corresponding to the period 2005-2015 in accordance with their geographic location, heating-degree-days per year, cold-degree-days per year, hospital category depending on the number of beds, floor area, and number of workers. It was found that PCWC is greater in hospitals located in areas with greater heating-degree-days per year. The potential mean annual savings estimated were 8,600,000 m 3 of water equivalent to 15,000,000 euros, 4000 MWh energy, and 30,000 tons of CO 2 emissions. It was concluded that, to determine the mean annual water consumption, it is preferable to use the number of beds as reference indicator, and the value of the consumption as reference indicator was proposed as 103 m 3 per bed per year.

No abstract