The effect of postural freedom to increase the neutral positions during laparoscopic surgery

  • Horacio M. Pace-BedettiEmail author
  • José F. Dolz
  • José L. Martínez-de-Juan
  • Andrés Conejero
Original Paper


Laparoscopic technique has demonstrated numerous advantages compared to open conventional surgery. Nevertheless, this procedure increases the surgeons fatigue and thus, the potential to commit errors that may harm the patient during the operation. The post-surgery pain is also augmented because the surgeons are forced to adopt non-neutral postures during the practice. This study reveals how a postural freedom element could help surgeons to improve the postural hygiene. During this study, thirteen participants with and without previous experience in laparoscopic surgery performed a test with two instruments: a prototype that implement this postural freedom concept and a conventional fixed instrument. The results obtained indicate that the postural freedom element allows the participants to maintain neutral positions during greatest part of the experiment and suggest that the implementation of an articulated element could increases the neutral positions adopted during a real laparoscopic procedure. The use of the postural freedom concept allowed to the participants to reduce the awkward positions during upper limb motions and to reduce displacements, avoiding extreme abductions that are common with the conventional fixed instruments.


Motion analysis Laparoscopic surgery Ergonomics Medical devices Interactive design 



The authors are grateful to all surgeons and residents who participated in the study and all the team of the clinical simulation area of the “Hospital La Fe” for making this study possible.

Supplementary material

12008_2018_527_MOESM1_ESM.xlsx (7.5 mb)
Supplementary material 1 (XLSX 7670 kb)


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Instituto de Diseño y Fabricación (IDF)Universidad Politécnica de ValenciaValenciaSpain
  2. 2.Hospital la Fe de ValenciaValenciaSpain
  3. 3.Centro de Investigación e Innovación en Bioingeniería (CI2B)Universidad Politécnica de ValenciaValenciaSpain

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