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Erschienen in: Surgical Endoscopy 5/2014

01.05.2014

Ergonomic assessment of the French and American position for laparoscopic cholecystectomy in the MIS Suite

verfasst von: Kelvin H. Kramp, Marc J. van Det, Eric R. Totte, Christiaan Hoff, Jean-Pierre E. N. Pierie

Erschienen in: Surgical Endoscopy | Ausgabe 5/2014

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Abstract

Background

Cholecystectomy was one of the first surgical procedures to be performed with laparoscopy in the 1980s. Currently, two operation setups generally are used to perform a laparoscopic cholecystectomy: the French and the American position. In the French position, the patient lies in the lithotomy position, whereas in the American position, the patient lies supine with the left arm in abduction. To find an ergonomic difference between the two operation setups the movements of the surgeon’s vertebral column were analyzed in a crossover study.

Methods

The posture of the surgeon’s vertebral column was recorded intraoperatively using an electromagnetic motion-tracking system with three sensors attached to the head and to the trunk at the levels of Th1 and S1. A three-dimensional posture analysis of the cervical and thoracolumbar spine was performed to evaluate four surgeons removing a gallbladder in the French and American position. The body angles assessed were flexion/extension of the cervical and thoracolumbar spine, axial rotation of the cervical and thoracolumbar spine, lateroflexion of the cervical and thoracolumbar spine, and the orientation of the head in the sagittal plane. For each body angle, the mean, the percentage of operation time within an ergonomic acceptable range, and the relative frequencies were calculated and compared.

Results

No statistical difference was observed in the mean body angles or in the percentages of operation time within an acceptable range between the French and the American position. The relative frequencies of the body angles might indicate a trend toward slight thoracolumbar flexion in the French position.

Conclusion

In a modern dedicated minimally invasive surgery suite, the body posture of the neck and trunk and the orientation of the head did not differ significantly between the French and American position.
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Metadaten
Titel
Ergonomic assessment of the French and American position for laparoscopic cholecystectomy in the MIS Suite
verfasst von
Kelvin H. Kramp
Marc J. van Det
Eric R. Totte
Christiaan Hoff
Jean-Pierre E. N. Pierie
Publikationsdatum
01.05.2014
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 5/2014
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3353-1

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