Skip to main content
SpringerLink
Log in

Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

To investigate the influence of the working surface height on task performance and muscle workload in hand-assisted laparoscopic surgery.

Methods

The standard task used was closure of 5-cm enterotomy inside a hand-assisted laparoscopic surgery trainer. Surgeons were instructed to place the sutures 3–5 mm apart and from the enterotomy edge. Ten surgeons participated in each experiment and one task was performed with each level. The first experiment compared the quality of task performance and muscle workload with the working surface at: elbow level, 10 cm above, 15 cm above and 10 cm below the elbow. Further narrower levels (5 cm below, at the elbow and 5 cm above the elbow) were investigated in the second experiment. Outcome measures were execution time (s), placement error score (mm), leakage pressure (mmHg), number of execution errors, muscle workload as measured by integrated electromyography (mV·s) and visual analogue score of back discomfort (mm).

Results

The first experiment showed that 15 cm above the elbow level was associated with the longest execution time and similar quality of task performance. This level resulted in a higher workload of the deltoid of the extracorporeal limb, the arm extensor of the intracorporeal side and the trapezius and paraspinal muscles of both intra- and extracorporeal limbs. Also, the 10 cm above the elbow level was associated with increased muscle workload of the deltoid of extracorporeal limb and the trapezius of both limbs compared with the elbow height. The 10 cm below the elbow level was associated with increased back discomfort. The second experiment showed that 5 cm below the elbow height was associated with increased muscle workload of the arm flexor group of the intracorporeal dominant limb.

Conclusions

The optimum table height for hand-assisted laparoscopic surgery allows the working surface of the extracorporal instrument handle to be at or 5 cm above the elbow level.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ayoub MM (1973) Work place design and posture. Hum Factors 15:265–268

    PubMed  CAS  Google Scholar 

  2. Berguer R, Smith WD, Davis S (2002) An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc 16:416–421

    Article  Google Scholar 

  3. Manasnayakorn S, Cuschieri A, Hanna GB (2007) Ideal manipulation angle and instrument length in hand-assisted laparoscopic surgery. Surg Endosc 22:924–929

    Article  PubMed  Google Scholar 

  4. Manasnayakorn S, Hanna GB, Khan F, Levison R, Cuschieri A (2004) The effect of the Omniport™ on the cutaneous microvascular activity of the hand. In: The 12th International Congress of the European Association for Endoscopic Surgery and other interventional Techniques (EAES)

  5. Cuschieri A, Frank TG, Brown S, Martin D, Gove JL (2003) A new multitool for hand-assisted advanced laparoscopic surgery (HALS). Surg Endosc 17:1368–1371

    Article  PubMed  CAS  Google Scholar 

  6. Joice P, Hanna GB, Cuschieri A (1998) Errors enacted during endoscopic surgery—a human reliability analysis. Appl Ergon 29:409–414

    Article  PubMed  CAS  Google Scholar 

  7. Tang B, Hanna GB, Joice P, Cuschieri A (2004) Identification and categorization of technical errors by Observational Clinical Human Reliability Assessment (OCHRA) during laparoscopic cholecystectomy. Arch Surg 139:1215–1220

    Article  PubMed  CAS  Google Scholar 

  8. Senders JW, Moray NP (1991) Human error: cause, prediction, and reduction. Lawrence Erlbaum, Hillsdale, NJ

    Google Scholar 

  9. van Veelen MA, Kazemier G, Koopman J, Goossens RH, Meijer DW (2002) Assessment of the ergonomically optimal operating surface height for laparoscopic surgery. J Laparoendosc Adv Surg Tech A 12:47–52

    Article  PubMed  Google Scholar 

  10. Ahmed S, Hanna GB, Cuschieri A (2004) Optimal angle between instrument shaft and handle for laparoscopic bowel suturing. Arch Surg 139:89–92

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to all surgeons participated in the study. The author would also like to thank the Royal Thai Government for providing supports.

Author information

Authors and Affiliations

  1. Department of Biosurgery and Surgical Technology, Imperial College London, St Mary’s Hospital, 10th floor, QEQM Building, St. Mary’s Hospital, Praed Street, London, W2 1NY, UK

    Sopark Manasnayakorn & George B. Hanna

  2. Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Sopark Manasnayakorn

  3. Division of Medical Sciences, Scuola Superiore S’Anna di Studi Universitari, Pisa, 56127, Italy

    Alfred Cuschieri

Authors
  1. Sopark Manasnayakorn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alfred Cuschieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George B. Hanna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to George B. Hanna.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manasnayakorn, S., Cuschieri, A. & Hanna, G.B. Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery. Surg Endosc 23, 783–789 (2009). https://doi.org/10.1007/s00464-008-0068-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-0068-9

Keywords

Search

Navigation