| Title | Comparative assessment of surgeons' task performance and surgical ergonomics associated with conventional and modified flank positions: a simulation study |
| Authors | Fan, Yu Kong, Gaiqing Meng, Yisen Tan, Shutao Wei, Kunlin Zhang, Qian Jin, Jie |
| Affiliation | Peking Univ, Hosp 1, Dept Urol, Beijing 100034, Peoples R China. Peking Univ, Hosp 1, Inst Urol, Beijing 100034, Peoples R China. Peking Univ, Dept Psychol, Beijing 100080, Peoples R China. China Med Univ, Shengjing Hosp, Shenyang, Peoples R China. |
| Keywords | Flank position Task performance Surgical ergonomics Retroperitoneoscopic MINIMALLY INVASIVE SURGERY LAPAROSCOPIC SURGERY GUIDELINES MOVEMENTS FATIGUE |
| Issue Date | 2014 |
| Publisher | surgical endoscopy and other interventional techniques |
| Citation | SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES.2014,28,(11),3249-3256. |
| Abstract | Flank position is extensively used in retroperitoneoscopic urological practice. Most surgeons follow the patients' position in open approaches. However, surgical ergonomics of the conventional position in the retroperitoneoscopic surgery is poor. We introduce a modified position and evaluated task performance and surgical ergonomics of both positions with simulated surgical tasks. Twenty-one novice surgeons were recruited to perform four tasks: bead transfer, ring transfer, continuous suturing, and cutting a circle. The conventional position was simulated by setting an endo-surgical simulator parallel to the long axis of a surgical desk. The modified position was simulated by rotating the simulator 30A degrees with respect to the long axis of the desk. The outcome measurements include task performance measures, kinematic measures for body alignment, surface electromyography, relative loading between feet, and subjective ratings of fatigue. We observed significant improvements in both task performance and surgical ergonomics parameters under the modified position. For all four tasks, subjects finished tasks faster with higher accuracy (p < 0.005 or < 0.001). For ergonomics part: (1) The angle between the upper body and the head was decreased by 7.4 +/- A 1.7A degrees; (2) The EMG amplitude collected from shoulders and left lumber was significantly lower (p < 0.05); (3) Relative loading between feet was more balanced (p < 0.001); (4) Manual-action muscles and postural muscles are rated less fatiguing according to the questionnaire (p < 0.05). Conventional position of patient in retroperitoneoscopic upper urinary tract surgery is associated with poor surgical ergonomics. With a simulated surgery, we demonstrated that our modified position could significantly improve task performance and surgical ergonomics. Further studies are still warranted to validate these benefits for both patients and surgeons. |
| URI | http://hdl.handle.net/20.500.11897/303998 |
| ISSN | 0930-2794 |
| DOI | 10.1007/s00464-014-3598-3 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 第一医院 心理与认知科学学院 |
