School of Design, Hunan University, Changsha 410082, China.
Int J Environ Res Public Health. 2023 Jan 29;20(3):2361. doi: 10.3390/ijerph20032361.
Laparoscopic surgery (LS) has been shown to provide great benefits to patients compared with open surgery. However, surgeons experience discomfort, low-efficiency, and even musculoskeletal disorders (MSDs) because of the poor ergonomic design of laparoscopic instruments. A methodology for the ergonomic design of laparoscopic dissector handles considering three-dimensional (3D) hand anthropometry and dynamic hand positions was addressed in this research. Two types of hand positions for grasping and stretching were scanned from 21 volunteers using a high-resolution 3D scanner. The 3D anthropometric data were extracted from these 3D hand pose models and used to design an improved handle (IH) that provides additional support for the thumb, a better fit to the purlicue, and a more flexible grasp for the index finger. Thirty subjects were invited to evaluate the IH in terms of muscular effort, goniometric study of motion, and efficiency and effectiveness during four trials of a laparoscopic training task. Questionnaires provided subjective parameters for ergonomic assessment. Positive results included less muscle load in the trapezius as well as significant but small angular differences in the upper limb. No significant reduction in the trial time and no increased percentage of the achievement were observed between the IH and the commercial handle (CH). Improved intuitiveness, comfort, precision, stability, and overall satisfaction were reported. IH provides significant ergonomic advantages in laparoscopic training tasks, demonstrating that the proposed methodology based on 3D anthropometry is a powerful tool for the handle design of laparoscopic dissectors and other surgical instruments.
与开放式手术相比，腹腔镜手术（LS）已被证明可为患者带来诸多益处。然而，由于腹腔镜器械的人体工程学设计不佳，外科医生会感到不适、效率低下，甚至出现肌肉骨骼疾病（MSD）。本研究提出了一种考虑三维（3D）手人体测量学和动态手位置的腹腔镜解剖器手柄人体工程学设计方法。使用高分辨率 3D 扫描仪从 21 名志愿者中扫描了两种用于抓握和拉伸的手位置。从这些 3D 手姿势模型中提取 3D 人体测量数据，并用于设计改进的手柄（IH），为拇指提供额外的支撑，更好地贴合小指，并为食指提供更灵活的抓握。邀请 30 名受试者在四项腹腔镜训练任务中评估 IH 在肌肉用力、运动角度研究以及效率和效果方面的表现。问卷调查提供了人体工程学评估的主观参数。结果积极，包括斜方肌的肌肉负荷减轻，以及上肢的角度差异虽小但显著。在 IH 和商业手柄（CH）之间，未观察到试验时间的显著缩短，也未观察到完成率的提高。报告显示 IH 在腹腔镜训练任务中具有显著的人体工程学优势，这表明基于 3D 人体测量学的提出方法是腹腔镜解剖器和其他手术器械手柄设计的强大工具。
