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Analysis of Hand Size and Ergonomics of Instruments in Pediatric Minimally Invasive Surgery
Claudia Filisetti1, Alexander Cho, Giovanna Riccipetitoni
1*Department of Paediatric Surgery, Chelsea Children's Hospital, Chelsea †Westminster Hospital NHS Foundation Trust, Imperial College, London, UK ‡Department of Paediatric Surgery, V. Buzzi Children's Hospital §University of Pavia, PhD School of Experimental Surgery and Microsurgery, Milan, Italy.
Insights
Pediatric surgeons reported difficulty with specialized laparoscopic instruments, particularly endobags and staplers. Hand surgery or double gloving did not significantly impact instrument usability in minimally invasive surgery.
Area of Science:
- Surgical Technology
- Minimally Invasive Surgery
- Pediatric Surgery
- Ergonomics
Background:
- Ergonomic considerations are crucial for surgical instrument design and effectiveness.
- Previous studies focused on adult surgeons; this research addresses pediatric minimally invasive surgery (MIS) ergonomics.
- Understanding instrument usability in pediatric MIS is vital for optimizing surgical outcomes and surgeon comfort.
Purpose of the Study:
- To evaluate the ergonomic challenges faced by pediatric surgeons using various minimally invasive surgical instruments.
- To compare the difficulty scores (DS) associated with different instrument sizes and types in pediatric MIS.
- To investigate the influence of factors like prior hand surgery and double gloving on instrument usability.
Main Methods:
- An online survey was distributed to members of the European Paediatric Surgeons' Association.
- The survey included 14 questions covering demographics, glove use, hand surgery history, and perceived difficulty with laparoscopic instruments.
- A total of 138 pediatric surgeons participated in the survey.
Main Results:
- Difficulty scores (DS) were comparable between 3.5-mm and 5-mm instruments.
- Specialized instruments like Ligasure, Ultracision, clip applicators, endobags, and staplers exhibited higher DS.
- The needle holder, a standard 5-mm instrument, also showed a higher DS; endobag and stapler difficulty was not statistically significant.
Conclusions:
- Certain specialized instruments in pediatric MIS present greater ergonomic challenges compared to standard ones.
- Prior hand surgery or the use of double gloves did not significantly correlate with increased difficulty in using MIS instruments.
- Further ergonomic refinement of specialized instruments like endobags and staplers may be beneficial for pediatric surgeons.
Abstract:
Moving from the study conducted in 2004 on adult surgeons we want to analyze the ergonomics applied in pediatric minimally invasive surgery. An online survey was conducted among the members of the European Paediatric Surgeons' Association that included 14 questions pertaining to demographic, surgical glove size, double glove use, prior hand surgery, and the ease or difficulty in using different types of laparoscopic instruments. A total of 138 pediatric surgeons completed the survey. The difficulty score (DS) was similar between the 3.5- and 5-mm instruments. Other specialized instruments such as Ligasure, Ultracision, Clip applicators, endobags, and staplers were found to have higher DS. The needle holder was the only instrument that is part of the normal 5-mm operating sets, which was found to have a higher DS. Our survey found increased DS with the endobag and stapler, but this was not significant. Also prior hand surgery or double glove use was not associated with difficulty in usage of minimally invasive instruments when compared with normal hands in this survey.
