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Ergonomics: requirements for adjusting the height of laparoscopic operating tables.
JSLS. 2001 Jan-Mar; 5(1):7-12.JSLS

Abstract

BACKGROUND AND OBJECTIVES

In the last few years many new instruments and devices have been developed and introduced into the operating room (OR). A debate has been ongoing about the optimal ergonomic posture for the operating staff. From practical experience, we have learned that the operating tables cannot be adjusted adequately to allow surgeons of different stature to maintain a comfortable posture. The goal of this study was to establish the most ergonomic table height for the particular physique of the surgeon and the different types of laparoscopic instrument handles that he or she uses.

METHODS

In a simulated model, two probands of different stature (50th [BS 50] and 95th [BS 95] percentile) used laparoscopic instruments with four different handle designs (shank, pistol, axial, and rod). The instruments were inserted into a board in three different angles ([IA] = 20 degrees, 30 degrees, 40 degrees). Additionally the elbow angles (EA) of the volunteers were fixed to either 90 degrees or 120 degrees. For every variable (size of surgeon and his or her elbow angle, design of handle, insertion angle of the instrument) the height of the board, as a parameter for the level of the abdominal wall of a patient with pneumoperitioneum, was measured from the floor.

RESULTS

All parameters had an effect on the optimal operating table height. The lowest required operating table level was 30 cm, the highest was 60.5 cm. In laparoscopic surgery-long shafted instruments and patients with pneumoperitoneum-the tabletops are too high for over 95% of all surgeons. As skin incision and wound suture are performed the conventional way, the operating tabletop must be adjustable up to the common height of 122 cm. The maximal difference between the optimal heights of the OR-table for one volunteer using two different handles with different insertion angles of the instruments (BS 95, EA 90 degrees, IA 20 degrees, rod handle to BS 50, EA 120 degrees, IA 40 degrees, axial handle) was about 27 cm.

CONCLUSION

New operating tables with a much lower adjustability are necessary to fulfill ergonomic requirements. The use of differently designed handles can hinder the ergonomic posture of the surgeon, because each handle requires a different working height.

Authors+Show Affiliations

Department of General Surgery, University-Hospital of Freiburg, Germany. matern@ch11.uk.uni-freiburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11303999

Citation

Matern, U, et al. "Ergonomics: Requirements for Adjusting the Height of Laparoscopic Operating Tables." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 5, no. 1, 2001, pp. 7-12.
Matern U, Waller P, Giebmeyer C, et al. Ergonomics: requirements for adjusting the height of laparoscopic operating tables. JSLS. 2001;5(1):7-12.
Matern, U., Waller, P., Giebmeyer, C., Rückauer, K. D., & Farthmann, E. H. (2001). Ergonomics: requirements for adjusting the height of laparoscopic operating tables. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 5(1), 7-12.
Matern U, et al. Ergonomics: Requirements for Adjusting the Height of Laparoscopic Operating Tables. JSLS. 2001 Jan-Mar;5(1):7-12. PubMed PMID: 11303999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ergonomics: requirements for adjusting the height of laparoscopic operating tables. AU - Matern,U, AU - Waller,P, AU - Giebmeyer,C, AU - Rückauer,K D, AU - Farthmann,E H, PY - 2001/4/17/pubmed PY - 2001/6/29/medline PY - 2001/4/17/entrez SP - 7 EP - 12 JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 5 IS - 1 N2 - BACKGROUND AND OBJECTIVES: In the last few years many new instruments and devices have been developed and introduced into the operating room (OR). A debate has been ongoing about the optimal ergonomic posture for the operating staff. From practical experience, we have learned that the operating tables cannot be adjusted adequately to allow surgeons of different stature to maintain a comfortable posture. The goal of this study was to establish the most ergonomic table height for the particular physique of the surgeon and the different types of laparoscopic instrument handles that he or she uses. METHODS: In a simulated model, two probands of different stature (50th [BS 50] and 95th [BS 95] percentile) used laparoscopic instruments with four different handle designs (shank, pistol, axial, and rod). The instruments were inserted into a board in three different angles ([IA] = 20 degrees, 30 degrees, 40 degrees). Additionally the elbow angles (EA) of the volunteers were fixed to either 90 degrees or 120 degrees. For every variable (size of surgeon and his or her elbow angle, design of handle, insertion angle of the instrument) the height of the board, as a parameter for the level of the abdominal wall of a patient with pneumoperitioneum, was measured from the floor. RESULTS: All parameters had an effect on the optimal operating table height. The lowest required operating table level was 30 cm, the highest was 60.5 cm. In laparoscopic surgery-long shafted instruments and patients with pneumoperitoneum-the tabletops are too high for over 95% of all surgeons. As skin incision and wound suture are performed the conventional way, the operating tabletop must be adjustable up to the common height of 122 cm. The maximal difference between the optimal heights of the OR-table for one volunteer using two different handles with different insertion angles of the instruments (BS 95, EA 90 degrees, IA 20 degrees, rod handle to BS 50, EA 120 degrees, IA 40 degrees, axial handle) was about 27 cm. CONCLUSION: New operating tables with a much lower adjustability are necessary to fulfill ergonomic requirements. The use of differently designed handles can hinder the ergonomic posture of the surgeon, because each handle requires a different working height. SN - 1086-8089 UR - https://www.unboundmedicine.com/medline/citation/11303999/Ergonomics:_requirements_for_adjusting_the_height_of_laparoscopic_operating_tables_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/11303999/ DB - PRIME DP - Unbound Medicine ER -