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Ergonomics for laparoscopic surgeon
1. Understanding Ergonomics
&
Its Importance In Laparoscopic Surgery
Dr.S.Easwaramoorthy
MS FRCS(Eng) FRCS (Glas) FRCS (Edin)
Head of Dept of Minimal Access Surgery
Examiner, RCS of Edinburgh
Executive Member, South Zone IAGES
FIAGES Board member
2. 2 D Image
No depth Perception
No tactile feedback
Counter-intuitive
Limited movements
Magnification
3. Open Surgeon Vs Lap Surgeon
How do they differ?!
Open Surgeon
• Fast
• Hand is as good as eyes
• Dissection precedes
• Ergonomics: Optional
Laparoscopic Surgeon
• Slow and steady
• Stop when you don’t see
• Haemostasis precedes
• Ergonomics: Vital
4. To be an efficient Surgeon…
• Equipments
• Environment
Concentrate on
21. Ergonomics of Hand Instruments
• Tip
– Range of movements
• Conventional Vs Robotic instrument
– Force transmission
• Length of the shaft
• Handle design
24. Ideal Relaxed Position
-straight head, in the axis of the trunk,
without rotation or extension of the cervical spine;
- shoulders in a relaxed and neutral position;
- arms alongside the body
- elbows bent to 70 to 90 degrees
- forearms in an horizontal or slightly descending axis-
-hands pronated (physiological resting position);
- hands and fingers lightly grip the handles/handpiece
•Waist line table
•Gaze down view of monitor
•Straight line principle
•Triangulation