Page 57 - World Journal of Laparoscopic Surgery

Role of OT Table Height on the Task Performance of Minimal Access Surgery

could be done with complimentary increased abduction of 2. Berguer R. Surgical technology and the ergonomics of laparoscopic
shoulder joint 75 degree and increased flexion and ulnar deviation instruments. Surg Endosc 1998;12:458-62.
of the wrist joint. 3. Berguer R, Forkley DL, Smith WD. Ergonomic problems
The comfortable height of the OR table was from 65 to 90 cm associated with laparoscopic surgery. Surg Endosc 1999;13:466-
for short and tall stature subjects respectively. For the mean 8.
height of the subjects 165 to 170 the comfortable OR table height 4. Schurr MO, Buess GF, Witcth F, Saile HJ, Botsch M, Ergonomic
surgeons’ chair for use during minimally ergonomic invasive
was 80 cm. These OR table height were considered comfortable surgery. Surg Laparosc Percutan Tech 1999;7:244-7.
for the corresponding subject height because they had more 5. Berguer R, Gerber S, Kilpatrick G, Beckley D. An ergonomic
freedom in movement and had less discomfort in the backs comparison of in-line vs pistol grip handle con-I, figuration in a
shoulder and wrist. laparoscopic grasper. Surg Endosc 1997;12:805-8.
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Tendick et al were the first investigators to show the 6. Berguer R, Rab GT, Abu-Ghaida H, Alarcon A, Chung J. A
manipulation problems in laparoscopic surgery emphasizing comparison of surgeon’s posture during laparoscopic and open
the negative effect on the surgeon’s dexterity of the narrow surgical postures. Surg Endosc 1996;11:139-42.
degree of freedom with use of laparoscopic instruments. Patkin 7. Matern U, Waller P. Instruments for minimally invasive surgery:
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and Isabel further reviewed human interface problems in Principles of ergonomics-handles. Surg Endosc 1999;13:174-82.
laparoscopic surgery and identified the need for a human 8. Van Veelen MA, Meijer DW. Ergonomics and design of
engineering (ergonomic) approach to the design of the laparoscopic instruments: Results of a survey among
laparoscopic surgeons. J Laparoendosc Adv Surg Tech A
laparoscopic operating environment. A 1997 survey conducted 1999;6:481-9.
by the Society of American Gastrointestinal Endoscopic Surgery 9. Van Veelen MA, Meijer DW, Goossens RHM, Snijders CJ.
(SAGES) found an 8-12% incidences of pain or numbness in New ergonomic design criteria for handles of laparoscopic
the upper extremities following laparoscopic surgery. dissection forceps. J Laparoendosc Adv Surg Tech A 2001;11:17-
Although the primary aim of the operation is not the comfort 26.
of the surgeon, the data reported by Hanna et al show that 10. Van Veelen MA, Meijer DW, Goossens RHM, Snijders O,
inefficient working postures directly affect the working efficiency Jakimowicz N. Improved usability of a new handle design for
of the surgeon. laparoscopic dissection forceps. Surg Endosc 2002;16:201-7.
The study shows that OR table height is less than that used 11. Berguer R. The application of ergonomics in the work
for open surgery. The surgeon should adjust his/her OR table environment of general surgeons. Rev Environ Health 1997;12:99-
106.
height corresponding to his own height according to the table 12. Bergure R. Surgical technology and the ergonomics of laparoscopic
and graph which we have discussed. instruments. Uurg Endosc 1998;12;458-62.
After analyzing the ration of surgeon’s height with the OR 13. Laparoscopic Surgery update. Reduced fatigue and discomfort:
table height we hypothesized that the OR table height should tips to improve operating room setup. Laparoscopic Surgery
be Surgeon’s Height into 0.49. Update. 1997;5;97-100.
14. De Quervain F. Zur Operationstischfrage. Zentrabl Chir
OR Table Height = Surgeon’s Height × 0.49 1906;11;321-3.
15. De Quervain F. Weiteres zur Operationstischfrage. Zentralbl
Chir 1909;19:686-8.
CONCLUSION 16. Grandjean E. Ergonomie in der Praxis. Kaln: Schriftreihe
Arbeitswissenschaftdes Arbeitgeberverbandes der
In this study it was observed laparoscopic OR table height has Metallindustrie; 1982.
an effect on the upper joint movements. The laparoscopic OR 17. Ayoub MM. Work place design and posture. Hum Factors
table height should vary from 65 to 90 cm from the floor. The 1973;15:265-8.
surgeon should be able to adjust the OR table corresponding 18. Matern U, Waller P, Giebmeyer C, Ruckauer KD, Farthmann
to his/her height in order to bring upper joint movements to the EH: Ergonomics: Requirements for adjusting the height of
minimum position with the resultant less discomfort in the laparoscopic operating tables. JSLS 2001;5:7-12.
shoulder, back elbow and the wrist. 19. RK Mishra. Textbook of Laparoscopic Surgery.
20. Tendik F, Jennings RW, Tharp G, Strak L. Sensing and
REFERENCES manipulation problems in endoscopic surgery: experiment,
analysis, and observation. Presence 1993;2:66-80.
1. Salvendy G. Handbook of Human Factor and Ergonomics, New 21. Patkin M, Isabel L. Ergonomics, engineering and surgery of
York: Wiley, 1997. endosurgical dissection. J R CoIl Surg Edinb 1995;40:120-32.

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