Determination of the Ideal Posture for the Surgeon During Laparoscopic Surgery

Cas Van ‘t Hullenaar, MD, Maarten Van Alphen, BSc, Matthijs Hendriks, BSc, Ivo Broeders, Professor. Meander Medical Center, Amersfoort / University Medical Center Utrecht/ Twente University, Eschede

 

Abstract

Background:
Physical discomfort is frequently reported by surgeons performing endoscopic procedures. Musculoskeletal fatigue and other physical complaints during laparoscopy can result in work related injuries for the surgeon and can potentially compromise patient’s safety. Therefore improvement of ergonomics is of major importance. In this study, the ideal posture for endoscopic surgery was recorded in an experimental environment.

Materials and methods:
In this study the ideal posture was measured in 22 subjects holding laparoscopic instruments. An optical motion capture camera system with infrared reflective markers (VICON, 8 cameras with infrared technology) was applied to detect position. From these data joint angles and posture of the subjects were defined. All data were collected and processed using Matlab R2010a®.

Results:
Subjects demonstrated an optimal position with slight flexion of the cervical spine (average 10°), a 20° abduction of the upper arms and an anteflexion of 15° in the shoulder. A flexed position of the elbows (average 96°) was considered most comfortable. Minimal rotation in the torso (below 5°) and a moderate angle between the instruments (average 27°) was recorded.

Conclusion:
The ideal posture in an experimental environment was determined. This will serve as background for future ergonomic studies in the operating theatre.
 


Session Number: SS02 – Instrumentation / Ergonomics
Program Number: S010

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