Ce diaporama a bien été signalé.

Ergonomics for laparoscopic surgeon

43

Partager

Chargement dans…3
×
1 sur 25
1 sur 25

Plus De Contenu Connexe

Livres associés

Gratuit avec un essai de 14 jours de Scribd

Tout voir

Livres audio associés

Gratuit avec un essai de 14 jours de Scribd

Tout voir

Ergonomics for laparoscopic surgeon

  1. 1. Understanding Ergonomics & Its Importance In Laparoscopic Surgery Dr.S.Easwaramoorthy MS FRCS(Eng) FRCS (Glas) FRCS (Edin) Head of Dept of Minimal Access Surgery Examiner, RCS of Edinburgh Executive Member, South Zone IAGES FIAGES Board member
  2. 2. 2 D Image No depth Perception No tactile feedback Counter-intuitive Limited movements Magnification
  3. 3. Open Surgeon Vs Lap Surgeon How do they differ?! Open Surgeon • Fast • Hand is as good as eyes • Dissection precedes • Ergonomics: Optional Laparoscopic Surgeon • Slow and steady • Stop when you don’t see • Haemostasis precedes • Ergonomics: Vital
  4. 4. To be an efficient Surgeon… • Equipments • Environment Concentrate on
  5. 5. Ergonomics • Straight Line principle • Triangulation • Manipulation angle • Elevation angle • Low lying table • Gaze down view
  6. 6. Straight Line Principle Surgeon Pathology Monitor
  7. 7. Visual Axis and Motor Axis
  8. 8. Co Axial alignment
  9. 9. Base Ball Diamond Concept & Triangulation Monitor S C R L P
  10. 10. Manipulation angle Azimuth Angle Manipulation Angle 30-45 degree 60-90 degree
  11. 11. Elevation angle
  12. 12. Ideal angles! 1. Manipulatation angle: 60 degree 2. Azimuth angle: Equal/30 degree each 3. Elevation angle: 60 degree
  13. 13. SILS Experience Energy Sources Equipments Co axial instruments Endo eye laparoscope Spider system SILS Ports
  14. 14. 360 degree rotation/Roticulation Endo eye
  15. 15. Ergonomics with SILS Spider System Intra abdominal Triangulation!
  16. 16. Ergonomics of Hand Instruments • Tip – Range of movements • Conventional Vs Robotic instrument: 4: 7
  17. 17. Da Vinci Robot Wrist like action PrecisionPrecision
  18. 18. Ergonomics of Hand Instruments • Tip – Range of movements • Conventional Vs Robotic instrument • Length of the shaft
  19. 19. Fulcrum Effect of Hand Instruments 1: 1
  20. 20. Ergonomics of Port Placement
  21. 21. Ergonomics of Hand Instruments • Tip – Range of movements • Conventional Vs Robotic instrument – Force transmission • Length of the shaft • Handle design
  22. 22. Ergonomic handles…
  23. 23. Surgeon’s Stance Ideal relaxed stature Tiring
  24. 24. Ideal Relaxed Position -straight head, in the axis of the trunk, without rotation or extension of the cervical spine; - shoulders in a relaxed and neutral position; - arms alongside the body - elbows bent to 70 to 90 degrees - forearms in an horizontal or slightly descending axis- -hands pronated (physiological resting position); - hands and fingers lightly grip the handles/handpiece •Waist line table •Gaze down view of monitor •Straight line principle •Triangulation

×