MP14-12 IMPROVED TASK PERFORMANCE AND SURGICAL ERGONOMICS WITH MODIFIED PATIENTS¡¯ POSITIONS DURING RETROPERITONEOSCOPIC UPPER URINARY TRACT SURGERY: A SIMULATION STUDY

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment II1 Apr 2014MP14-12 IMPROVED TASK PERFORMANCE AND SURGICAL ERGONOMICS WITH MODIFIED PATIENTS¡¯ POSITIONS DURING RETROPERITONEOSCOPIC UPPER URINARY TRACT SURGERY: A SIMULATION STUDY Yu Fan, Gaiqing Kong, Kunlin Wei, Qian Zhang, and Jie Jin Yu FanYu Fan More articles by this author , Gaiqing KongGaiqing Kong More articles by this author , Kunlin WeiKunlin Wei More articles by this author , Qian ZhangQian Zhang More articles by this author , and Jie JinJie Jin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.640AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Retroperitoneoscopic upper urinary tract surgery is extensively used in urological practice. Most surgeons follow the patients¡¯ position in open approaches. However, surgical ergonomics of the conventional position in the retroperitoneoscopic surgery is poor. We introduce a modified position and evaluated task performance and surgical ergonomics of both positions with simulated surgical tasks. METHODS Twenty-one novice surgeons were recruited to perform four tasks: bead transfer, ring transfer, continuous suturing and cutting a circle. The conventional position was simulated by setting an endo-surgical simulator parallel to the long axis of a surgical desk. The modified position was simulated by rotating the simulator 30¡ãwith respect to the long axis of the desk. The outcome measurements include task performance measures, kinematic measures for body alignment, surface electromyography, relative loading between feet and subjective ratings of fatigue. RESULTS We observed significant improvements in both task performance and surgical ergonomics parameters under the modified po□0…1sition. For all four tasks, subjects finished tasks faster with higher accuracy (p<0.005 or <0.001). For ergonomics part: 1. The angle between the upper body and the head was decreased by 7.4¡À1.7¡ã; 2. The EMG amplitude collected from shoulders and left lumber was significantly lower (p<0.05); 3. Relative loading between feet was more balanced (p<0.001); 4. manual-action muscles and postural muscles are rated less fatiguing according to the questionnaire (p<0.05). CONCLUSIONS Conventional position of patient in retroperitoneoscopic upper urinary tract surgery is associated with poor surgical ergonomics. With a simulated surgery, we demonstrated that our modified position could significantly improve task performance and surgical ergonomics. Further studies are still warranted to validate these benefits for both patients and surgeons. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e172 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Yu Fan More articles by this author Gaiqing Kong More articles by this author Kunlin Wei More articles by this author Qian Zhang More articles by this author Jie Jin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...