SURGICAL TECHNOLOGY AND THE ERGONOMICS OF LAPAROSCOPIC INSTRUMENTS

Laparoscopic surgery provides patients with less painful surgery and a more rapid recovery, while requiring that surgeons work harder and in a more remote manner from the operating field. Cost-containment press ures on surgeons demand efficient surgery, whereas the increased techn ological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparos copic surgery. There is, therefore, a need to evaluate the ergonomic i ntegration and suitability of the laparoscopic operating room environm ent to address the issues of efficiency, safety, and comfort for the o perating team. This approach is particularly important in the design o f laparoscopic surgical instruments. A review of the literature on the biomechanics of laparoscopic surgical instrument use was combined wit h data from the Society of American Gastrointestinal and Endoscopic Su rgeons (SAGES) Ergonomics Questionnaire and demonstration station. Lap aroscopic instruments suffer from ergonomically inadequate handle desi gns and inefficient handle to tip force transmission, which lead to su rgeon fatigue, discomfort, and hand paresthesias. Improvements in the design of laparoscopic instruments are needed to decrease the work and discomfort of tissue manipulation during video-endoscopic surgery.