Ergonomic problems associated with laparoscopic surgery

Background: The Society of American Gastrointestinal Endoscopic Surgeons (S AGES) Task Force on Ergonomics conducted a subjective and objective assessm ent of ergonomic problems associated with laparoscopic instrument use. The goal was to assess the prevalence, causes, and consequences of operational difficulties associated with the use of laparoscopic instruments. Methods: A questionnaire was distributed asking respondents to rate the fre quency with which they experienced pain, stiffness, or numbness in several body areas after laparoscopic operations. An ergonomics station was assembl ed to quantify forearm and thumb muscle workload. Processed electromyogram (EMG) signals were acquired from 27 volunteer surgeon subjects while they c ompleted simulated surgical tasks using a hemostat and an Ethicon(R) laparo scopic grasper, with the aid of an endoscopic trainer and video monitoring system. Results: Of 149 surgeons responding to the questionnaire, 8% to 12% reporte d frequent pain in the neck and upper extremities associated with laparosco pic surgery. The ergonomics station demonstrated that: the peak and total m uscle effort of forearm and thumb muscles were significantly greater (p < 0 .01) when the grasping task was performed using the laparoscopic instrument rather than the hemostat. Conclusion: These findings indicate that laparoscopic surgical technique is more taxing on the surgeon.