The effect of ergonomic laparoscopic tool handle design on performance and efficiency
The effect of ergonomic laparoscopic tool handle design on performance and efficiency
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DOI：
10.1007/s00464-014-4005-9
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发表时间：
2015-09-01
影响因子：
3.1
通讯作者：
Merryweather, Andrew S.
中科院分区：
文献类型：
--
作者：
Tung, Kryztopher D.;Shorti, Rami M.;Merryweather, Andrew S.
许多因素会影响外科医生在手术室中的表现;这些因素可能包括外科医生的舒适度、工具手柄设计的人体工程学和疲劳。根据人体工程学考虑设计的腹腔镜工具手柄（手枪式握把）与具有传统捏握手柄的当前市售工具进行了测试。本研究的目的是量化人体工程学设计考虑因素对外科医生表现的影响。我们假设，当使用两种工具手柄设计执行FLS手术训练器任务时，在三个类别中的效率之间存在可测量的差异：完成时间，技术技能和主观用户rates.The手枪式握把结合了人体工程学界面，旨在减少手和手指上的接触应力点，促进更中性的操作手腕姿势，并减少手震颤和疲劳。传统的夹持器是由斯特赖克公司开发的腹腔镜工具。在微创手术中广泛使用。本研究选择了23名（13名男性，10名女性）无上肢肌肉骨骼疾病或腹腔镜手术经验的受试者。在测试前的培训课程中，参与者使用这两种工具在SAGES FLS培训器中进行了实践试验。在数据收集过程中，参与者使用两种手柄设计执行了三项评价任务（顺序随机化，每个试验完成三次）。测试参与者的反馈表明，他们在每个类别中都更喜欢符合人体工程学的手枪式握把（p < 0.05）;最值得注意的是，参与者在使用捏握工具后手部感到更大程度的不适。此外，参与者使用手枪式握把比使用捏握式握把在更短的时间内完成切割和桩钉转移任务（p < 0.05）;完成切割任务的时间之间没有显著差异。最后，工具类型和试验过程中的错误之间没有显著的相互作用。从调查反馈中可以看出，使用手枪式握把工具时，疼痛感明显降低。使用手枪式握把工具完成两项评价任务（切割和钉转移）的速度也明显更快。最后，由于误差数据的高度可变性，不可能得出关于工具设计对所犯误差的数量或程度的影响的任何有意义的结论。
Many factors can affect a surgeon's performance in the operating room; these may include surgeon comfort, ergonomics of tool handle design, and fatigue. A laparoscopic tool handle designed with ergonomic considerations (pistol grip) was tested against a current market tool with a traditional pinch grip handle. The goal of this study is to quantify the impact ergonomic design considerations which have on surgeon performance. We hypothesized that there will be measurable differences between the efficiency while performing FLS surgical trainer tasks when using both tool handle designs in three categories: time to completion, technical skill, and subjective user ratings.The pistol grip incorporates an ergonomic interface intended to reduce contact stress points on the hand and fingers, promote a more neutral operating wrist posture, and reduce hand tremor and fatigue. The traditional pinch grip is a laparoscopic tool developed by Stryker Inc. widely used during minimal invasive surgery. Twenty-three (13 M, 10 F) participants with no existing upper extremity musculoskeletal disorders or experience performing laparoscopic procedures were selected to perform in this study. During a training session prior to testing, participants performed practice trials in a SAGES FLS trainer with both tools. During data collection, participants performed three evaluation tasks using both handle designs (order was randomized, and each trial completed three times). The tasks consisted of FLS peg transfer, cutting, and suturing tasks.Feedback from test participants indicated that they significantly preferred the ergonomic pistol grip in every category (p < 0.05); most notably, participants experienced greater degrees of discomfort in their hands after using the pinch grip tool. Furthermore, participants completed cutting and peg transfer tasks in a shorter time duration (p < 0.05) with the pistol grip than with the pinch grip design; there was no significant difference between completion times for the suturing task. Finally, there was no significant interaction between tool type and errors made during trials.There was a significant preference for as well as lower pain experienced during use of the pistol grip tool as seen from the survey feedback. Both evaluation tasks (cutting and peg transfer) were also completed significantly faster with the pistol grip tool. Finally, due to the high degree of variability in the error data, it was not possible to draw any meaningful conclusions about the effect of tool design on the number or degree of errors made.