851 A NEW PLATFORM IMPROVING ERGONOMY OF LAPAROSCOPIC SURGERY: EXPERIMENTAL STUDIES AND INITIAL CLINICAL EVALUATION

Abstract

INTRODUCTION AND OBJECTIVES: Distribution of laparoscopic surgery is handicapped due to significant ergonomic limitations. We want to present experimental and clinical evaluation of a new operating chair used as a platform for laparoscopic surgery. METHODS: The surgical chair (ETHOS-platform) consists of a saddle-like seat, an adjustable chest-support, two individually adjustable armrests, and footrests. We compared suturing standing laterally to pelvi-trainer (“Torero-position”) versus standing behind pelvi-trainer and sitting on ETHOS. Every participant and surgeon (N 18) filled out a questionnaire focusing on ergonomic issues. Since August 2010, we performed 164 laparoscopic and retroperitoneoscopic procedures using ETHOS involving four different surgeons. Two frequent procedures (radical prostatectomy, pyeloplasty) underwent detailed comparison to matched-paired patients from our laparoscopic database. RESULTS: Ex-vivo, there was no significant different anastomotic time standing behind pelvi-trainer and sitting on ETHOS; the difference became significant compared to Torero-position mimicking clinical scenario (44.4 vs. 37.6 minutes). Independent from laparoscopic experience and workload complaints (total score) were significantly less with ETHOS-assistance (31.6 vs. 13.9). In-vivo comparison did not show different OR-times, but revealed statistically significant differences with respect to anastomotic times of ETHOS and DaVinci (23 vs. 19 vs. 19 minutes). CONCLUSIONS: Ergonomics of laparoscopy may be significantly improved by new platforms supporting the sitting position of the surgeon with armrests and integrated foot pedals.