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An ergonomic study of the optimum operating table height for laparoscopic surgery
R Berquer1, W D Smith, S Davis
1University of California Davis, School of Medicine, and VA Northern California Health Care System, 150 Muir Road (112), Martinez, CCA 94553, USA. rberguer@dnai.com
Surgical Endoscopy
|April 3, 2002
Summary
The optimal operating room table height for laparoscopic surgery is near elbow level for surgeons. This ergonomic adjustment minimizes surgeon discomfort and reduces muscle strain during procedures.
Area of Science:
- Ergonomics in Surgery
- Minimally Invasive Procedures
- Surgical Safety and Efficiency
Background:
- Laparoscopic surgery necessitates longer instruments, altering the surgeon's hand-to-table height relationship compared to open surgery.
- Determining the optimal operating table height is crucial for surgeon comfort and performance during laparoscopic procedures.
Purpose of the Study:
- To investigate the ideal operating room table height for laparoscopic surgery.
- To identify ergonomic parameters that minimize surgeon discomfort and physical strain.
Main Methods:
- Twenty-one surgeons performed standardized tasks at varying instrument handle heights relative to their elbow height.
- Subjective ratings of discomfort and difficulty were collected using visual analog scales.
- Physiological measures including skin conductance (SC), electromyography (EMG) of shoulder muscles, and arm orientation were recorded.
Main Results:
- Significant differences in discomfort, deltoid and trapezius muscle EMG activity, and arm elevation were observed across different instrument handle heights.
- Lowest discomfort and difficulty ratings occurred when instrument handles were at elbow height.
- EMG activity and arm elevation decreased as instrument handle height was lowered.
Conclusions:
- Positioning laparoscopic instrument handles near surgeon elbow level is recommended to minimize discomfort and muscle workload.
- An optimal operating table height of approximately 64 to 77 cm is suggested for laparoscopic surgery.
- Current operating room table designs may require modification to meet these ergonomic recommendations.