Monitor position in laparoscopic surgery.

Area of Science:

• Minimally Invasive Surgery
• Surgical Ergonomics
• Human Factors Engineering

Background:

• Laparoscopic surgery presents challenges with monitor placement, impacting surgeon ergonomics.
• This study investigates the relationship between monitor position, muscle strain, and task performance in simulated laparoscopic procedures.

Purpose of the Study:

• To evaluate the effect of different monitor positions on neck muscle strain and task performance during simulated laparoscopy.
• To determine the optimal monitor setup for laparoscopic surgery based on objective measurements and subjective preferences.

Main Methods:

• Eighteen subjects performed simulated laparoscopic suturing tasks with the monitor in three positions: frontal eye-level (A), frontal operating field height (B), and 45-degree side (C).
• Electromyographic (EMG) activity of neck muscles was recorded, and task performance was quantified by the number of pearls threaded.
• Subjects indicated their preferred monitor position post-simulation.

Main Results:

• Electromyographic (EMG) activity was significantly lower in the frontal eye-level position (A) compared to side (C) and operating field height (B) positions.
• Task performance, measured by pearls threaded, was highest in the operating field height position (B), significantly outperforming the side position (C).
• A majority of subjects preferred frontal monitor positions (A and B) and none preferred the side position (C).

Conclusions:

• Positioning the monitor frontally at eye level (A) is preferable for minimizing neck muscle strain.
• A dual-monitor setup, with one at eye level (A) and another at operating field height (B), offers the best balance of reduced neck strain and optimal task performance.
• Side monitor placement is not recommended due to increased muscle strain and potentially reduced performance.