Ergonomic Risk of Assisting in Minimally Invasive Surgery

Introduction: Ergonomic knowledge related to primary MIS surgeons has been well described. Similar studies making the camera assistant subject have not been undertaken. By simulating the assistant¡¯s role as a camera holder and retractor during a Nissen fundoplication, this study investigated how camera target locations and grip strategies, and fatigue affected the assistant¡¯s posture.
Methods and Procedures: Seven subjects were studied while performing a camera navigating task. A training box on an OR table simulated an adult patient in low lithotomy position. Each subject was asked to stand on two force plates at the left side of the simulated patient. A laparoscope was introduced into the training box in which four 2 cm circles as targets had been placed on the rear panel in the following locations to the assistant: (1) distal superior, (2) proximal superior, (3) distal inferior, (4) proximal inferior (TARGET). Subjects were instructed to hold the camera with their left hand and point it at a target with their task to match the target to a circle overlaid on the monitor. Simultaneously, a grasper in the right hand was used to grasp and pull one of two rubber bands on the panel. A minute signal moved the subject on to the next target. Each trial had 3 repetitions (PHASE) consisting of 4 targets. Subjects were asked to perform two separate trials, in which the camera was held from the top and then the bottom (GRIP). A 4x3x2 (TARGETxPHASExGRIP) repeated measures design was used for statistical analysis. Weight loading ratio (WLR) was calculated from the vertical ground reaction forces (VGRF) from left force plate and total VGRF from both plates. WLR=(left VGRF)/(left VGRF+right VGRF)*100.
Results: WLR significantly increased (p

Session: Podium Presentation

Program Number: S050

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