Ergonomics in minimally invasive surgery

Elhage, Oussama; Murphy, Declan; Challacombe, Benjamin; Shortland, Adam

doi:10.1111/j.1742-1241.2006.01243.x

Cited by 25 publications

(13 citation statements)

References 11 publications

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“…Recent research, however, has demonstrated no effect of either position on an increase in BDI [23]. A postulation was recently put forth that the American technique may not result in the most favorable ergonomic posture [6]. Our study establishes that the American side-standing technique does pose a risk of physical injury for the surgeon in comparison with the between-standing French technique.…”

Section: Discussionsupporting

confidence: 71%

“…These include deliberate exposure of the Calot's triangle [2], establishment of the ''critical view'' [3], and use of the ''top-down'' (retrograde dissection) technique [4]. Little beyond description and speculation, however, has been published about the surgeon's standing position or use of the one-versus two-handed technique [5][6][7][8], and currently there are no agreed-upon recommendations in terms of how these two primary elements affect LC performance [9].…”

mentioning

confidence: 99%

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Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

et al. 2011

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Laparoscopic cholecystectomy poses a risk of physical injury to the surgeon. As LC is currently commonly performed in the United States, the left side-standing position may lead to increased physical demand and effort, resulting in ergonomically unsound conditions for the surgeon. Though further investigations should be conducted, adopting the between-standing position deserves serious consideration as it may be the best short-term ergonomic alternative.

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Section: Discussionsupporting

confidence: 71%

mentioning

confidence: 99%

Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

et al. 2011

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“…Apart from superior visualization and articulated instrumentation, the improved ergonomic position offered at the robotic console benefits the surgeon during prolonged procedures [11]. In 2003, Menon et al first reported the feasibility of RLRC using the da Vinci® surgical system [10].…”

Section: Discussionmentioning

confidence: 99%

Initial Experiences with Robot-Assisted Laparoscopic Radical Cystectomy

Kwon

Kim

et al. 2010

Korean J Urol

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PurposeRobot-assisted laparoscopic radical cystectomy (RLRC) is a new option for the treatment of muscle-invasive bladder cancer, and case series for RLRC have been increasing recently. We report our operative technique and initial experiences with RLRC with extracorporeal urinary diversion.Materials and MethodsBetween October 2008 and November 2009, 17 consecutive patients with muscle-invasive bladder cancer underwent RLRC, pelvic lymph node dissection, and extracorporeal urinary diversion. Urinary diversion included 13 ileal conduits and 4 orthotopic neobladders (Studer method). Data were collected prospectively on patient demographics, intraoperative parameters, pathologic staging, and postoperative outcomes.ResultsThe mean patient age was 63.7 years. The mean body mass index was 22.6 kg/m2. No patients had a history of previous abdominal surgery. The mean operative time was 379.1 minutes, including 32.6 minutes for pelvic lymph node dissection, 185.2 minutes for RLRC, and 159.4 minutes for urinary diversion. The mean estimated blood loss was 210.5 ml. The mean hospital stay was 20.7 days and the mean time to oral intake and ambulation was 5.0 and 1.3 days, respectively. There were no major perioperative complications. The pathologic reports showed urothelial cell carcinomas in all cases.ConclusionsOur initial clinical experiences indicate that RLRC with pelvic lymph node dissection and extracorporeal urinary diversion is a safe and feasible procedure with minimal blood loss and rapid recovery. Long-term follow up in a larger patient population is needed to determine the true oncological and functional benefit of this procedure.

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“…Robot-assisted Minimally Invasive Surgery (RMIS) has come to the forefront in the last decades since this technology can provide enhanced dexterity and 3D perception of the surgical field. These advantages produce a surgical approach that is more ergonomic for surgeons and safer for patients, as described in Elhage et al (2007). Specifically, RMIS allows the surgeon to access small and complex anatomical districts (e.g., digestive tract), and perform surgery with reduced invasiveness and in a more intuitive and confident way according to Pavan et al (2016).…”

Section: Introductionmentioning

confidence: 99%

Design and Integration of Electrical Bio-impedance Sensing in Surgical Robotic Tools for Tissue Identification and Display

et al. 2019

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The integration of intra-operative sensors into surgical robots is a hot research topic since this can significantly facilitate complex surgical procedures by enhancing surgical awareness with real-time tissue information. However, currently available intra-operative sensing technologies are mainly based on image processing and force feedback, which normally require heavy computation or complicated hardware modifications of existing surgical tools. This paper presents the design and integration of electrical bio-impedance sensing into a commercial surgical robot tool, leading to the creation of a novel smart instrument that allows the identification of tissues by simply touching them. In addition, an advanced user interface is designed to provide guidance during the use of the system and to allow augmented-reality visualization of the tissue identification results. The proposed system imposes minor hardware modifications to an existing surgical tool, but adds the capability to provide a wealth of data about the tissue being manipulated. This has great potential to allow the surgeon (or an autonomous robotic system) to better understand the surgical environment. To evaluate the system, a series of ex-vivo experiments were conducted. The experimental results demonstrate that the proposed sensing system can successfully identify different tissue types with 100% classification accuracy. In addition, the user interface was shown to effectively and intuitively guide the user to measure the electrical impedance of the target tissue, presenting the identification results as augmented-reality markers for simple and immediate recognition.

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Ergonomics in minimally invasive surgery

Cited by 25 publications

References 11 publications

Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

Initial Experiences with Robot-Assisted Laparoscopic Radical Cystectomy

Design and Integration of Electrical Bio-impedance Sensing in Surgical Robotic Tools for Tissue Identification and Display

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