Sánchez-Margallo Francisco M, Pérez-Duarte Francisco J, Sánchez-Margallo Juan A, Lucas-Hernández Marcos, Matos-Azevedo Ana Maria, Díaz-Güemes Idoia
Minimally Invasive Surgery Centre Jesús Usón/ Scientific Direction , Cáceres , Spain.
Minim Invasive Ther Allied Technol. 2014 Dec;23(6):350-6. doi: 10.3109/13645706.2014.925928. Epub 2014 Jun 9.
This study aims to analyze the surgeons' hand spatial configuration during the use of two different instrument handles for laparoscopy, by obtaining information from the data glove CyberGlove®, and establishing existing risk levels for wrist disorders.
Fifty surgeons participated in this study and were distributed into three groups (novices, intermediate and experts). Each subject carried out suturing and dissection tasks on a physical simulator, using axial-handled or ring-handled instruments, respectively. Hand and wrist positions were registered by the CyberGlove® and a modified RULA method was applied to establish appropriate risk levels for wrist disorders.
We found statistically significant differences in seven of the eleven glove sensors when comparing both tasks. RULA method showed that all subjects, with the exception of the experts using an axial-handled instrument, assume a prejudicial wrist posture during the practice of suturing and dissection tasks on the simulator.
Data glove CyberGlove® allows for the distinction between two laparoscopic exercises performed with different instruments. Also, laparoscopic intracorporeal suturing when performed with an axial-handled needle holder entails a more ergonomic posture for the wrist joint. Previous minimally invasive surgical experience is a positive influencing factor on the surgeons' wrist postures during laparoscopy.
本研究旨在通过从数据手套CyberGlove®获取信息,并确定手腕疾病的现有风险水平,分析外科医生在使用两种不同的腹腔镜器械手柄时手部的空间配置。
五十名外科医生参与了本研究,他们被分为三组(新手、中级和专家)。每个受试者分别使用轴向手柄或环形手柄器械在物理模拟器上进行缝合和解剖任务。通过CyberGlove®记录手和手腕的位置,并应用改良的RULA方法确定手腕疾病的适当风险水平。
在比较两项任务时,我们发现十一个手套传感器中的七个存在统计学上的显著差异。RULA方法表明,除了使用轴向手柄器械的专家外,所有受试者在模拟器上进行缝合和解剖任务时都采取了有害的手腕姿势。
数据手套CyberGlove®能够区分使用不同器械进行的两种腹腔镜操作。此外,使用轴向手柄持针器进行腹腔镜体内缝合时,手腕关节的姿势更符合人体工程学。先前的微创手术经验是影响腹腔镜手术中外科医生手腕姿势的一个积极因素。