van Det M J, Meijerink W J H J, Hoff C, Totté E R, Pierie J P E N
Department of Surgery, Leeuwarden Medical Center, PO Box 888, 8901 BR, Leeuwarden, The Netherlands.
Surg Endosc. 2009 Jun;23(6):1279-85. doi: 10.1007/s00464-008-0148-x. Epub 2008 Oct 2.
With minimally invasive surgery (MIS), a man-machine environment was brought into the operating room, which created mental and physical challenges for the operating team. The science of ergonomics analyzes these challenges and formulates guidelines for creating a work environment that is safe and comfortable for its operators while effectiveness and efficiency of the process are maintained. This review aimed to formulate the ergonomic challenges related to monitor positioning in MIS. Background and guidelines are formulated for optimal ergonomic monitor positioning within the possibilities of the modern MIS suite, using multiple monitors suspended from the ceiling.
All evidence-based experimental ergonomic studies conducted in the fields of laparoscopic surgery and applied ergonomics for other professions working with a display were identified by PubMed searches and selected for quality and applicability. Data from ergonomic studies were evaluated in terms of effectiveness and efficiency as well as comfort and safety aspects. Recommendations for individual monitor positioning are formulated to create a personal balance between these two ergonomic aspects.
Misalignment in the eye-hand-target axis because of limited freedom in monitor positioning is recognized as an important ergonomic drawback during MIS. Realignment of the eye-hand-target axis improves personal values of comfort and safety as well as procedural values of effectiveness and efficiency.
Monitor position is an important ergonomic factor during MIS. In the horizontal plain, the monitor should be straight in front of each person and aligned with the forearm-instrument motor axis to avoid axial rotation of the spine. In the sagittal plain, the monitor should be positioned lower than eye level to avoid neck extension.
随着微创手术（MIS）的出现，人机环境被引入手术室，这给手术团队带来了身心挑战。人体工程学分析这些挑战，并制定指导方针，以创造一个对操作人员安全舒适的工作环境，同时保持手术过程的有效性和效率。本综述旨在阐述与微创手术中显示器定位相关的人体工程学挑战。利用从天花板上悬挂的多个显示器，在现代微创手术套件的可能性范围内，为最佳人体工程学显示器定位制定背景和指导方针。
通过PubMed检索，确定在腹腔镜手术领域以及应用人体工程学于其他使用显示器的职业中进行的所有基于证据的实验性人体工程学研究，并根据质量和适用性进行选择。从有效性、效率以及舒适性和安全性方面对人体工程学研究数据进行评估。制定关于单个显示器定位的建议，以在这两个人体工程学方面之间实现个人平衡。
由于显示器定位自由度有限，眼-手-目标轴的不对准被认为是微创手术期间一个重要的人体工程学缺陷。眼-手-目标轴的重新对齐可提高舒适性和安全性的个人价值以及有效性和效率的手术价值。
显示器位置是微创手术期间一个重要的人体工程学因素。在水平平面上，显示器应直接位于每个人的前方，并与前臂-器械运动轴对齐，以避免脊柱轴向旋转。在矢状平面上，显示器应放置在低于眼睛水平的位置，以避免颈部伸展。
