Berguer R
Department of Surgery, University of California Davis, Sacramento, CA 94553, USA.
Surg Endosc. 1998 May;12(5):458-62. doi: 10.1007/s004649900705.
Laparoscopic surgery provides patients with less painful surgery and a more rapid recovery, while requiring that surgeons work harder and in a more remote manner from the operating field. Cost-containment pressures on surgeons demand efficient surgery, whereas the increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. There is, therefore, a need to evaluate the ergonomic integration and suitability of the laparoscopic operating room environment to address the issues of efficiency, safety, and comfort for the operating team. This approach is particularly important in the design of laparoscopic surgical instruments. A review of the literature on the biomechanics of laparoscopic surgical instrument use was combined with data from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Ergonomics Questionnaire and demonstration station. Laparoscopic instruments suffer from ergonomically inadequate handle designs and inefficient handle to tip force transmission, which lead to surgeon fatigue, discomfort, and hand paresthesias. Improvements in the design of laparoscopic instruments are needed to decrease the work and discomfort of tissue manipulation during video-endoscopic surgery.
腹腔镜手术为患者提供了痛苦较小的手术体验和更快的恢复速度，同时要求外科医生更加努力地工作，且与手术区域的距离更远。外科医生面临的成本控制压力要求手术高效进行，然而技术复杂性的增加以及有时不太适配的设备导致腹腔镜手术期间外科医生疲劳和不适的抱怨增多。因此，有必要评估腹腔镜手术室环境的人体工程学整合及适用性，以解决手术团队的效率、安全和舒适度问题。这种方法在腹腔镜手术器械的设计中尤为重要。对关于腹腔镜手术器械使用生物力学的文献综述与来自美国胃肠和内镜外科医生协会（SAGES）人体工程学问卷及示范站的数据相结合。腹腔镜器械存在人体工程学设计不足以及手柄到尖端的力传递效率低下的问题，这会导致外科医生疲劳、不适和手部感觉异常。需要改进腹腔镜器械的设计，以减少视频内镜手术期间组织操作的工作量和不适感。
