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Ergonomics perspective for identifying and reducing internal operative flow disruption for laparoscopic urological
Latif Al-Hakim1,2, Jiaquan Xiao3, Shomik Sengupta4
1Division of Information Technology and Mathematical Sciences, University of South Australia, Adelaide, Australia. Latif.al-hakim@unisa.edu.au.
Surgical Endoscopy
|April 30, 2017
Summary
Poor operating room ergonomics significantly increase internal operative flow disruption (OFD) during urological laparoscopies. Optimizing the surgical environment can nearly halve delays and improve surgeon performance.
Area of Science:
- Urology
- Surgical Technology
- Ergonomics
Background:
- Investigates internal operative flow disruption (OFD) during urological laparoscopies.
- Examines the link between OFD and external ergonomic factors.
- First study of its kind to analyze OFD in relation to surgical environment.
Purpose of the Study:
- To identify and categorize internal operative flow disruption (OFD) events in urological laparoscopies.
- To correlate OFD events with specific ergonomic factors in the operating room.
- To quantify the impact of ergonomics on operative efficiency.
Main Methods:
- Combined real-time and video-aided observational study in Australia and China.
- Brainstorming sessions to identify OFD causes and ergonomic factors.
- Prospective observational analysis of 24 laparoscopic procedures categorized by ergonomics.
Main Results:
- Identified 39 types of internal OFD events stemming from six root causes.
- Procedures in unsatisfactory ergonomic environments (Group B) showed nearly double the OFD events (29/h) compared to satisfactory environments (Group A, <15/h).
- A total of 1178 OFD events caused a 7.43% delay (220 min) in operative time.
Conclusions:
- Non-physiological and prolonged static postures are key ergonomic factors impacting surgeon performance.
- Suboptimal external ergonomics nearly doubled operative flow disruptions and delays.
- Strategic pauses and communication during long procedures may positively influence surgeon performance.
