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Improved Laparoscopic Ergonomics?

Published: November 5, 2012

It's no secret that laparoscopic surgery is an ergonomic nightmare for docs, but now a researcher at the University of Connecticut Health Center in Farmington is hoping to reduce the repetitive strain injuries often suffered by surgeons specializing in minimally invasive techniques.

Donald Peterson, head of the center's biodynamics laboratory in the division of occupational and environmental medicine, is using opto-electronic motion-capture technology to measure the physical strain various laparoscopic techniques put on surgeons.

Mr. Peterson — who said at this year's SAGES conference in San Diego that at least 85% of laparoscopic surgeons experience discomfort in their shoulders and upper extremities — attached electrodes to the forearm muscles that control hand movements to measure muscle activity and fatigue. He also placed sensors on laparoscopic instruments to measure how much force surgeons use to push and pull the devices during surgery.

He discovered that surgeons are constantly applying about 3 pounds of pressure and 3 to 4 pounds of torque to instruments as they're using them, which can lead to numbness and tingling in the hands and arms. Mr. Paterson hopes his research leads to improved laparoscopic instrument designs and, ultimately, a more ergonomically friendly OR.

Related research published in the Journal of Urology by Richard Babayan, MD, chief of the department of urology at Boston University School of Medicine in Massachusetts, suggests laparoscopic surgeons who perform warm-up exercises — 15 to 20 minutes of suturing exercises (forehand and backhand sutures and knot-tying), using both hands — before complex procedures perform surgery quicker.

"Completing warm-up exercises before athletic competition or stage performance is very common," writes Dr. Babayan, "However, most surgeons do not warm-up before performing complex surgery, even though it may improve operative times and their performance."

Daniel Cook

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