Initial experience of a novel ergonomic surgical chair for laparoscopic pelvic surgery

Abstract

Introduction:We present the initial experience of a novel surgical chair for laparoscopic pelvic surgery, the ETHOS TM (Bridge City Surgical, Portland, OR). Materials and Methods:The ETHOS chair has an adjustable saddle height that ranges from 0.89 to 1.22 m high, an overall width of 0.89 m, and a depth of 0.97 m. The open straddle is 0.53 m and fits most OR tables. We performed 7 pelvic laparoscopy cases with the 1 st generation ETHOS TM platform including 2 laparoscopic ureteral reimplantations, 5 laparoscopic pelvic lymphadenectomies for staging prostate cancer in which one case involved a laparoscopic radical retropubic prostatectomy, performed by 2 different surgeons. Results: All 7 pelvic laparoscopic procedures were successful with the ETHOS TM chair. No conversion to open surgery was necessary. Survey done by surgeons after the procedures revealed minimal stress on back or upper extremities by the surgeons from these operations even when surgery was longer than 120 minutes. Conversely, the surgical assistants still had issues with their positions since they were on either sides of the patient stressing their positions during the procedure. Conclusion: The ETHOS chair system allows the surgeon to operate seated in comfortable position with ergonomic chest, arms, and back supports. These supports minimize surgeon fatigue and discomfort during pelvic laparoscopic procedures even when these procedures are longer than 120 minutes without consequence to the patient safety or detrimental effects to the surgical team.

The burden of performing minimal access surgery: ergonomics survey results from 462 surgeons across Germany, the UK and the USA

“…Although studies have demonstrated some improvement in mental focus and reduction in musculoskeletal pain and fatigue with TSMBs [ 21 , 28 ], complete effectiveness in the long term is yet to be seen. In the case of RAS, an ergonomic operating chair may help improve comfort by maintaining a correct posture while operating [ 29 ].…”

Direct Comparison of the Different Conventional Laparoscopic Positions with the Ethos Surgical Platform in a Laparoscopic Pelvic Surgery Simulation Setting

“…Its clinical feasibility was initially proved, by Kim et al, in a limited number of laparoscopic pelvic urological procedures. 9 Rassweiler et al 10 using also the ETHOS prototype extended its clinical evaluation by comparing 53 consecutive ETHOS-assisted laparoscopic radical prostatectomies with 53 robotically assisted radical prostatectomies and 53 conventional laparoscopic radical prostatectomies, in a matched-paired analysis, according to different ergonomic parameters. The questionnaires proved the superiority of robotic pelvic surgery.…”

“…As a result, the negative effects of a nonergonomic posture, the chronic limited body movement without weight shifting, and the nonergonomic design of different surgical instruments, became more apparent, 8 especially when performing complex pelvic procedures such as a laparoscopic radical prostatectomy. 7 Based on previously published preliminary clinical experience using the prototype, 9,10 we present the experimental evaluation of the second-generation operating chair (ETHOSÔ). This platform is designed to improve the ergonomics of laparoscopic procedures, by comparing it with the two different conventional laparoscopic positions during laparoscopic suturing and vesicourethral anastomosis, in a training room setting.…”

The Minimally Invasive Manipulator: An ergonomic and economic non-robotic alternative for endoscopy?

“…The latter is mainly associated with pelvic laparoscopy (24). Half of the expert sessions and half of the novice sessions were done in line (COV1), as schematically depicted in Figure 5a and b.…”