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An ergonomic study of the optimum operating table height for laparoscopic surgery.
Surg Endosc. 2002 Mar; 16(3):416-21.SE

Abstract

BACKGROUND

Laparoscopic surgery requires the use of longer instruments than open surgery, thus changing the relation between the height of the surgeon's hands and the desirable height of the operating room table. The optimum height of the operating room table for laparoscopic surgery is investigated in this study.

METHODS

Twenty-one surgeons performed a two-handed, one-fourth circle cutting task using a laparoscopic video system and laparoscopic instruments positioned at five instrument handle heights relative to subjects' elbow height (-20, -10, 0, +10, and +20 cm) by adjusting the height of the trainer box. Subjects rated the difficulty and discomfort experienced during each task on a visual analog scale. Skin conductance (SC) was measured in Micromhos via paired surface electrodes placed near the ulnar edge of the palm of the right (cutting) hand. The mean electromyographic (EMG) signal from the right deltoid and trapezius muscles was measured. Arm orientation was measured in three dimensions using a magnetometer/accelerometer. Signals were acquired using analog circuitry and digitally sampled using a National Instruments DAQCard 700 connected to a Macintosh PowerBook 5300c running LabVIEW software. Statistical analysis was carried out by analysis of variance and post hoc testing.

RESULTS

Statistically significant changes were found in the subjective rating of discomfort (p <0.002), deltoid EMG (p <0.0006), trapezius EMG (p <0.0001), and arm elevation (p <0.0001) between instrument handle heights. SC values and task times did not change significantly. Discomfort and difficulty ratings were lowest when instrument handles were positioned at elbow height. EMG values and arm elevation all decreased with lower instrument height.

CONCLUSION

This study suggests that the optimum table height for laparoscopic surgery should position the laparoscopic instrument handles close to surgeons' elbow level to minimize discomfort and upper arm and shoulder muscle work. This corresponds to an approximate table height of 64 to 77 cm above floor level. A redesign of current operating room tables may be required to meet these ergonomic guidelines.

Authors+Show Affiliations

University of California Davis, School of Medicine, and VA Northern California Health Care System, 150 Muir Road (112), Martinez, CCA 94553, USA. rberguer@dnai.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

11928019

Citation

Berquer, R, et al. "An Ergonomic Study of the Optimum Operating Table Height for Laparoscopic Surgery." Surgical Endoscopy, vol. 16, no. 3, 2002, pp. 416-21.
Berquer R, Smith WD, Davis S. An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc. 2002;16(3):416-21.
Berquer, R., Smith, W. D., & Davis, S. (2002). An ergonomic study of the optimum operating table height for laparoscopic surgery. Surgical Endoscopy, 16(3), 416-21.
Berquer R, Smith WD, Davis S. An Ergonomic Study of the Optimum Operating Table Height for Laparoscopic Surgery. Surg Endosc. 2002;16(3):416-21. PubMed PMID: 11928019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An ergonomic study of the optimum operating table height for laparoscopic surgery. AU - Berquer,R, AU - Smith,W D, AU - Davis,S, Y1 - 2001/11/16/ PY - 2001/05/07/received PY - 2001/06/07/accepted PY - 2002/4/3/pubmed PY - 2002/5/7/medline PY - 2002/4/3/entrez SP - 416 EP - 21 JF - Surgical endoscopy JO - Surg Endosc VL - 16 IS - 3 N2 - BACKGROUND: Laparoscopic surgery requires the use of longer instruments than open surgery, thus changing the relation between the height of the surgeon's hands and the desirable height of the operating room table. The optimum height of the operating room table for laparoscopic surgery is investigated in this study. METHODS: Twenty-one surgeons performed a two-handed, one-fourth circle cutting task using a laparoscopic video system and laparoscopic instruments positioned at five instrument handle heights relative to subjects' elbow height (-20, -10, 0, +10, and +20 cm) by adjusting the height of the trainer box. Subjects rated the difficulty and discomfort experienced during each task on a visual analog scale. Skin conductance (SC) was measured in Micromhos via paired surface electrodes placed near the ulnar edge of the palm of the right (cutting) hand. The mean electromyographic (EMG) signal from the right deltoid and trapezius muscles was measured. Arm orientation was measured in three dimensions using a magnetometer/accelerometer. Signals were acquired using analog circuitry and digitally sampled using a National Instruments DAQCard 700 connected to a Macintosh PowerBook 5300c running LabVIEW software. Statistical analysis was carried out by analysis of variance and post hoc testing. RESULTS: Statistically significant changes were found in the subjective rating of discomfort (p <0.002), deltoid EMG (p <0.0006), trapezius EMG (p <0.0001), and arm elevation (p <0.0001) between instrument handle heights. SC values and task times did not change significantly. Discomfort and difficulty ratings were lowest when instrument handles were positioned at elbow height. EMG values and arm elevation all decreased with lower instrument height. CONCLUSION: This study suggests that the optimum table height for laparoscopic surgery should position the laparoscopic instrument handles close to surgeons' elbow level to minimize discomfort and upper arm and shoulder muscle work. This corresponds to an approximate table height of 64 to 77 cm above floor level. A redesign of current operating room tables may be required to meet these ergonomic guidelines. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/11928019/An_ergonomic_study_of_the_optimum_operating_table_height_for_laparoscopic_surgery_ L2 - https://doi.org/10.1007/s00464-001-8190-y DB - PRIME DP - Unbound Medicine ER -
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