van Veelen M A, Kazemier G, Koopman J, Goossens R H M, Meijer D W
Faculty of Design, Engineering and Production, Subfaculty Industrial Design Engineering, Delft University of Technology, The Netherlands.
J Laparoendosc Adv Surg Tech A. 2002 Feb;12(1):47-52. doi: 10.1089/109264202753486920.
The aim of this study was to find the ergonomically optimal operating surface height for laparoscopic surgery in order to reduce discomfort in the upper extremities of the operators and the assistants. The operating surface height was defined as the level of the abdominal wall of a patient with pneumoperitoneum.
Two pelvi-trainer tests were performed. One test was performed on six different operating surface heights. The (extreme) joint excursions of the shoulder, elbow, and wrist were measured by a video analysis method. Another test was performed by holding a laparoscope for 15 minutes while an electromyelograph of the biceps brachii was made. The results of both tests were evaluated subjectively by a questionnaire.
The ergonomically optimal operating surface height lies between a factor 0.7 and 0.8 of the elbow height of the operator/assistant. At this height, the joint excursions stay in the neutral zone for more than 90% of the total manipulation time, and the activity of the biceps brachii when holding the laparoscope stays within 15% of the maximum muscle activity.
The operating surface height influences the (extreme) upper joint excursions of the surgeon. The ergonomically optimal operating surface height reduces the discomfort in the shoulders, back, and wrists of the surgeon during laparoscopic surgery. This optimal table height range for laparoscopic surgery is lower than those currently available.
本研究的目的是找到腹腔镜手术符合人体工程学的最佳手术台面高度，以减轻术者和助手上肢的不适感。手术台面高度定义为气腹患者腹壁的水平高度。
进行了两项骨盆训练器测试。一项测试在六个不同的手术台面高度上进行。通过视频分析方法测量肩部、肘部和腕部的（极限）关节活动度。另一项测试是在手持腹腔镜15分钟的同时对肱二头肌进行肌电图检查。两项测试的结果均通过问卷调查进行主观评估。
符合人体工程学的最佳手术台面高度介于术者/助手肘部高度的0.7倍至0.8倍之间。在此高度下，关节活动度在总操作时间的90%以上保持在中性区域内，手持腹腔镜时肱二头肌的活动保持在最大肌肉活动的15%以内。
手术台面高度会影响外科医生上肢（极限）关节活动度。符合人体工程学的最佳手术台面高度可减轻腹腔镜手术期间外科医生肩部、背部和腕部的不适感。这种腹腔镜手术的最佳台面高度范围低于目前的高度。
