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Ergonomic comparison of laparoscopic hand instruments in a single site surgery simulator with novices.
Minim Invasive Ther Allied Technol. 2015 Apr; 24(2):68-76.MI

Abstract

BACKGROUND

Single-site surgery improves cosmesis but increases procedural difficulty. Enhanced instruments could improve procedural efficiency leading to better patient outcomes.

MATERIAL AND METHODS

One pair of non-articulating (straight) and two different pairs of articulating laparoscopic instruments were evaluated using a peg-transfer surgical task simulator by premedical college students. The instruments were comparatively tested using task performance measures, ergonomic measures, and participant questionnaires.

RESULTS

The straight instrument produced significantly higher task performance scores and lower task times compared to both articulating instruments (p < 0.05). The straight instrument required less muscle activation and less wrist deviation than the articulating instruments to perform the same task. Participants rated the straight instrument significantly easier to use and less difficult to complete the task than with either articulating instrument (p < 0.05 for both).

CONCLUSIONS

This exploratory study suggests that novices have difficulty using articulating instruments and perform better using straight laparoscopic instruments when first attempting LESS surgical tasks. Although a study with post-graduate medical trainees is needed to confirm these results, trainees should initially practice LESS with non-articulating instruments to gain proficiency at basic laparoscopic tasks. Additionally, redesigning articulating instruments to specifically address the spatial constraints and learning curve of LESS may also improve trainee performance and instrument usability.

Authors+Show Affiliations

University of Nebraska Medical Center , Omaha, NE , USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25142199

Citation

Riggle, Jakeb D., et al. "Ergonomic Comparison of Laparoscopic Hand Instruments in a Single Site Surgery Simulator With Novices." Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy, vol. 24, no. 2, 2015, pp. 68-76.
Riggle JD, Miller EE, McCrory B, et al. Ergonomic comparison of laparoscopic hand instruments in a single site surgery simulator with novices. Minim Invasive Ther Allied Technol. 2015;24(2):68-76.
Riggle, J. D., Miller, E. E., McCrory, B., Meitl, A., Lim, E., Hallbeck, M. S., & LaGrange, C. A. (2015). Ergonomic comparison of laparoscopic hand instruments in a single site surgery simulator with novices. Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy, 24(2), 68-76. https://doi.org/10.3109/13645706.2014.946426
Riggle JD, et al. Ergonomic Comparison of Laparoscopic Hand Instruments in a Single Site Surgery Simulator With Novices. Minim Invasive Ther Allied Technol. 2015;24(2):68-76. PubMed PMID: 25142199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ergonomic comparison of laparoscopic hand instruments in a single site surgery simulator with novices. AU - Riggle,Jakeb D, AU - Miller,Emily E, AU - McCrory,Bernadette, AU - Meitl,Alex, AU - Lim,Eric, AU - Hallbeck,M Susan, AU - LaGrange,Chad A, Y1 - 2014/08/21/ PY - 2014/8/22/entrez PY - 2014/8/22/pubmed PY - 2016/1/27/medline KW - SILS KW - ergonomics KW - simulation KW - single access laparoscopic surgery laparoscopic instruments SP - 68 EP - 76 JF - Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy JO - Minim Invasive Ther Allied Technol VL - 24 IS - 2 N2 - BACKGROUND: Single-site surgery improves cosmesis but increases procedural difficulty. Enhanced instruments could improve procedural efficiency leading to better patient outcomes. MATERIAL AND METHODS: One pair of non-articulating (straight) and two different pairs of articulating laparoscopic instruments were evaluated using a peg-transfer surgical task simulator by premedical college students. The instruments were comparatively tested using task performance measures, ergonomic measures, and participant questionnaires. RESULTS: The straight instrument produced significantly higher task performance scores and lower task times compared to both articulating instruments (p < 0.05). The straight instrument required less muscle activation and less wrist deviation than the articulating instruments to perform the same task. Participants rated the straight instrument significantly easier to use and less difficult to complete the task than with either articulating instrument (p < 0.05 for both). CONCLUSIONS: This exploratory study suggests that novices have difficulty using articulating instruments and perform better using straight laparoscopic instruments when first attempting LESS surgical tasks. Although a study with post-graduate medical trainees is needed to confirm these results, trainees should initially practice LESS with non-articulating instruments to gain proficiency at basic laparoscopic tasks. Additionally, redesigning articulating instruments to specifically address the spatial constraints and learning curve of LESS may also improve trainee performance and instrument usability. SN - 1365-2931 UR - https://www.unboundmedicine.com/medline/citation/25142199/Ergonomic_comparison_of_laparoscopic_hand_instruments_in_a_single_site_surgery_simulator_with_novices_ L2 - https://www.tandfonline.com/doi/full/10.3109/13645706.2014.946426 DB - PRIME DP - Unbound Medicine ER -