Ergonomics Problems Due to the Use and Design of Dissector and Needle Holder

Lucas-Hernández, Marcos; Pagador, J. Blas; Pérez-Duarte, Francisco J.; Castelló, Purificación; Sánchez‐Margallo, Francisco M.

doi:10.1097/sle.0b013e3182937fe8

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…Laparoscopic instruments are known to cause physical discomfort [15, 16] and, moreover, to cause injuries especially affecting the thumbs [17, 18]. Furthermore, almost all laparoscopic handles come with the adage “one size fits all” whereas small hand size is a known risk factor for experiencing physical discomfort and difficulties in the use of laparoscopic instruments [19–21].…”

Section: Introductionmentioning

confidence: 99%

Ergonomics of laparoscopic graspers and the importance of haptic feedback: the surgeons’ perspective

Alleblas

Vleugels²,

Nieboer

2016

Gynecol Surg

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Haptic feedback is drastically reduced in laparoscopic surgery compared to open surgery. Introducing enhanced haptic feedback in laparoscopic instruments might well improve surgical safety and efficiency. In the design process of a laparoscopic grasper with enhanced haptic feedback, handle design should be addressed to strive for optimal usability and comfort. Additionally, the surgeons’ perspective on the potential benefits of haptic feedback should be assessed to ascertain the clinical interest of enhanced haptic feedback. A questionnaire was designed to determine surgeons’ use and preferences for laparoscopic instruments and expectations about enhanced haptic feedback. Surgeons were also asked whether they experience physical complaints related to laparoscopic instruments. The questionnaire was distributed to a group of laparoscopic surgeons based in Europe. From the 279 contacted subjects, 98 completed the questionnaire (response rate 35 %). Of all respondents, 77 % reported physical complaints directly attributable to the use of laparoscopic instruments. No evident similarity in the main preference for graspers was found, either with or without haptic feedback. According to respondents, the added value of haptic feedback could be of particular use in feeling differences in tissue consistencies, feeling the applied pressure, locating a tumor or enlarged lymph node, feeling arterial pulse, and limiting strain in the surgeon’s hand. This study stresses that the high prevalence of physical complaints directly related to laparoscopic instruments among laparoscopic surgeons is still relevant. Furthermore, the potential benefits of enhanced haptic feedback in laparoscopic surgery are recognized by laparoscopic specialists. Therefore, haptic feedback is considered an unmet need in laparoscopy.

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Section: Introductionmentioning

confidence: 99%

Ergonomics of laparoscopic graspers and the importance of haptic feedback: the surgeons’ perspective

Alleblas

Vleugels²,

Nieboer

2016

Gynecol Surg

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“…The instrument handle is an essential part of laparoscopic instruments, whose inappropriate design can have a detrimental effect on the surgeon's efficiency and wellbeing [33]. The rate of work-related musculoskeletal disorders in laparoscopy are from 73% to 100%, with poor instrument handle design being one of the main risk factors [34,35]. In a survey by Santos-Carreras et al, they assessed the acceptance of different surgical instrument handle designs and they reported that conventional laparoscopic instrument handles such as the axial handle scored lowest in terms of comfort [36].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of the Use of Different Sizes of an Ergonomic Instrument Handle for Laparoscopic Surgery

et al. 2020

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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.

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“…Shoulder, neck, back, and hand pain and stiffness were reported as the main physical symptoms during laparoscopic procedures [36,37]. The surgeon's height, glove size, age, gender, type of instrument, foot pedals, and height of the operating table have been identified as important factors for increasing the musculoskeletal pain symptoms [38][39][40][41]. The shape of the laparoscopic instrument handle was identified as the main element that needed to be improved [40].…”

Section: Questionnairesmentioning

confidence: 99%

Ergonomics in Laparoscopic Surgery

Sánchez‐Margallo¹,

Sánchez‐Margallo²

2017

Laparoscopic Surgery

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Despite the many advantages for patients, laparoscopic surgery entails certain ergonomic inconveniences for surgeons, which may result in decreasing the surgeons' performance and musculoskeletal disorders. In this chapter, the current status of ergonomics in laparoscopy, laparoendoscopic single-site surgery (LESS), and robotassisted surgery will be reviewed. Ergonomic guidelines for laparoscopic surgical practice and methods for ergonomic assessment in surgery will be described. Results will be based on the scientific literature and our experience. Results showed that the surgeon's posture during laparoscopic surgery is mainly affected by the static body postures, the height of the operating table, the design of the surgical instruments, the position of the main screen, and the use of foot pedals. Ergonomics during the laparoscopic surgical practice is related to the level of experience. Better ergonomic conditions entail an improvement in task performance. Laparoscopic instruments with axial handle lead to a more ergonomic posture for the wrist compared to a ring handle. LESS is physically more demanding than conventional and hybrid approaches, requiring greater level of muscular activity in the back and arm muscles, but better wrist position compared with traditional laparoscopy. Physical and cognitive ergonomics with robotic assistance were significantly less challenging when compared to conventional laparoscopic surgery.

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Ergonomics Problems Due to the Use and Design of Dissector and Needle Holder

Abstract: As far as we know, this is the largest Spanish survey conducted on this topic. From this survey, some ergonomic drawbacks have been identified in: (a) the instruments' design, (b) the operating tables, and (c) the posture of the surgeons.

Cited by 12 publications

References 26 publications

Ergonomics of laparoscopic graspers and the importance of haptic feedback: the surgeons’ perspective

Ergonomics of laparoscopic graspers and the importance of haptic feedback: the surgeons’ perspective

Comparative Study of the Use of Different Sizes of an Ergonomic Instrument Handle for Laparoscopic Surgery

Ergonomics in Laparoscopic Surgery

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