Ergonomic port placement in laparoscopic colorectal surgery

Area of Science:

• Laparoscopic surgery
• Surgical ergonomics
• Colorectal surgery

Background:

• Port placement in laparoscopic surgery significantly impacts surgeon ergonomics and task efficiency.
• A manipulation angle (MA) of 60° is considered optimal for maximizing surgical task efficiency.

Purpose of the Study:

• To calculate the manipulation angle (MA) achieved with different port placements during laparoscopic right hemicolectomy (RH) and high anterior resection (AR).
• To evaluate which port configurations best approximate the optimal 60° MA for specific surgical maneuvers.

Main Methods:

• Two port placement strategies were evaluated for RH (RH-PP1, RH-PP2) and AR (AR-PP1, AR-PP2).
• The mean MA was calculated for key mobilization steps including the caecum, hepatic flexure, splenic flexure, descending-sigmoid junction, and recto-sigmoid junction.

Main Results:

• RH-PP2 yielded higher mean MAs (58°, 44°) for caecum and hepatic flexure mobilization compared to RH-PP1 (38°, 52°).
• AR-PP2 provided better MAs (40°, 56°, 34°) for splenic flexure, descending-sigmoid, and recto-sigmoid mobilization than AR-PP1 (77°, 41°, 18°).

Conclusions:

• Neither of the evaluated port placements consistently achieved the optimal 60° MA across all stages of RH or AR.
• Optimal MA varies depending on the specific anatomical region being mobilized during these resections.