Study of ergonomics in terms of angle of manipulation and angle of azimuth in laparoscopic splenectomy

Authors

  • Gaurav Joshi Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  • Khaja Abdul Moin Baig Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  • Aparajita Chaturvedi Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  • Jnaneshwari Jayaram Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  • Yashvant S. Rathore Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  • Sunil Chumber Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20212723

Keywords:

Laparoscopic splenectomy, Angle of manipulation, Angle of azimuth

Abstract

As per baseball diamond concept of port position, experimentally it is well known that putting camera port in the line of target organ and working port equidistant from camera port such that they form a 30º angle each gives optimum ergonomic advantage. However while performing laparoscopic surgeries in humans it is seldom possible to achieve such port position. No such study  has ever been attempted to find out value of angle of manipulation and angle of azimuth while performing laparoscopic procedure. Purpose of our study was to measure such angles in our patients during laparoscopic splenectomy (LS) and to verify the concept of baseball position of ports in the procedure. This was a prospective observational study where angle of manipulation between right and left working port of surgeon and angle of azimuth of both working instruments with the camera were measured intraoperatively. In our series of 12 patients who underwent LS in lateral position, we found angle of manipulation ranging from 41-85°. The azimuth angle between first working port (epigastric) and camera port was in the range of 22-45° and the azimuth angle between camera port and second working port was in the range of 19-40°. This was a first study that gave valuable insight into the application of theoretical concept of triangulation in port placement in LS. This study may guide the surgeons to measure and to modify the port position to gain advantage of better ergonomics and better long term health.

Author Biography

Gaurav Joshi, Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

Assistant Professor Department of Surgical Disciplines All India Institute of Medical Sciences New Delhi

References

Uhrich ML, Underwood RA, Standeven JW, Soper NJ, Engsberg JR. Assessment of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery. Surg Endosc. 2002;16(4):635-9.

Manasnayakorn S, Cuschieri A, Hanna GB. Ideal manipulation angle and instrument length in hand-assisted laparoscopic surgery. Surg Endosc. 2008;22(4):924-9.

Supe AN, Kulkarni GV, Supe PA. Ergonomics in laparoscopic surgery. J Minimal Access Surg. 2010;6(2):31-6.

Hanna GB, Shimi S, Cuschieri A. Optimal port locations for endoscopic intracorporeal knotting. Surg Endosc. 1997;11(4):397-401.

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Published

2021-06-28

Issue

Section

Short Communication