A feasibility study determining surgical ergonomics in a live surgical setting.

Study Objective: To identify the biomechanical movements of laparoscopic surgeons during laparoscopic gynecologic procedures, and to determine whether such movements can be assessed and measured both temporally and biomechanically.

Design: Prospective descriptive kinematic study (Canadian Task Force classification II-3).

Setting: A tertiary referral hospital in Sydney, Australia.

Study Subjects: Five gynecologic laparoscopic surgeons.

Interventions: Video recording from a variety of fixed positions to assess surgeon stance, time spent in specific postures, and relative change of limb angles during laparoscopic surgical procedures.

Measurements And Main Results: Postoperative review of surgical movements during laparoscopic surgery was able to provide quantitative data. Motion and timing could be classified by angle banding ranges among surgeons. The most extreme shoulder abduction angles occurred during trocar insertion (61°) and insertion or removal of laparoscopic instruments (63.5°), with procedures involving morcellation requiring the greatest number of instrument insertions or removals (n = 57). The elbow is most frequently in a neutral position in TLH, and the shoulder spends the most time in abduction during myomectomy.

Conclusion: This proof-of-concept study confirms that detailed ergonomic assessment is possible within live surgical settings, with identified limitations. This study may allow for a larger-scale study to determine at-risk movements during the various phases of a laparoscopic surgery and possibly control for some of these hazardous behaviors.