Ergonomic evaluation of a mechanical anastomotic stapler used by Japanese surgeons

Emiko Kono,Tomoko Matsuo,Yui Endo,Sachiyo Nomura,Mitsunori Tada,Yasuko Tomizawa,Makiko Kouchi

doi:10.1007/s00595-013-0666-6

Abstract

PurposeThe satisfaction rating of currently available mechanical staplers for Japanese surgeons with small hands is low. To identify the issue, we examined the relationship of hand dimensions and grip force with the operation force of a mechanical circular stapler.MethodsHand dimensions and grip force were measured in 113 Japanese surgeons (52 men and 61 women). We then evaluated the relationship between grip width and the operation force required to push the lever of the stapler, at three points on the lever, using a digital force gauge.ResultsThe optimal grip width of the dominant hand was 62.5 ± 8.5 mm for men and 55.5 ± 5.9 mm for women (p < 0.001). The maximum grip force of the dominant hand was 44.2 ± 6.1 kg for men and 29.7 ± 4.5 kg for women (p < 0.001) and the maximum operation force required to push the lever 7.0, 45.0, and 73.0 mm from the end of the lever was 21.8, 28.6, and 42.4 kg, respectively.ConclusionsTo our knowledge, this is the first ergonomic study of a surgical stapler to be conducted in Asia. Firing the stapler by gripping the proximal side of the lever is physically impossible for most Japanese women surgeons since the required operation force exceeds the maximum grip force, which probably accounts for the stress perceived by these women.

Highlights

In 1958, Professor Mine [1] developed and introduced the concept of a mechanical circular stapler in Japan
We examined the relationship of hand dimensions and grip force with the operation force of a mechanical circular stapler
Hand dimensions and grip force were measured in 113 Japanese surgeons (52 men and 61 women)

Summary

Introduction

In 1958, Professor Mine [1] developed and introduced the concept of a mechanical circular stapler in Japan. Most currently available mechanical anastomotic staplers are made in the United States and Europe. Among the mechanical anastomotic staplers, DST-EEA (Covidien, Mansfield, MA, USA) and CDH (Ethicon Co. Ethicon Endo-Surgery, Cincinnati, Ohio, USA) do not have handle size variation. Ethicon Endo-Surgery, Cincinnati, Ohio, USA) do not have handle size variation This creates an ergonomic issue for Japanese surgeons who have relatively smaller hand dimensions and weaker grip force than surgeons from North American and European countries

Methods

Results

Conclusion