OP 80. Ergonomics In Less Surgery: Use Of 1 Straight And 1 Articulated Instruments

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F. Pérez-Duarte, B. Fernández-Tomé, A Matos-Azevedo, J. Sánchez-Margallo, M. Lucas-Hernández, I. Días-Güemes Martín-Portugués, F. Sánchez-Margallo

Chair(s): György Wéber, Mehmet Fatih Can & Norbert Németh

8:50 - 9:00h at Pest Room (C)

Categories: Oral Session, Robotic and Minimal Invasive Surgery

Session: Oral Session IX - Robotic and Minimal Invasive Surgery

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Background
Laparoendoscopic single-site (LESS) surgery performed with two articulated instruments entails greater level of muscular activity than conventional laparoscopy. The objective of this study is to evaluate surgeons' ergonomy during LESS surgery, performed with the combination of one straight and one articulated instruments, by determining muscular workload and comparing it with the performance of conventional laparoscopy.

Material and Methods
The study group was composed of 24 surgeons, with different levels of previous experience.Each of the participants performed coordination and cut tasks on a physical simulator through Laparoscopy (LAP) and LESS. Straight standard laparoscopic instruments were used for LAP, whilst for LESS subjects had one straight (dominant hand) and one articulated instrument (non-dominant hand). During both tasks, muscular activity of biceps brachii, triceps brachii, forearm flexors and extensors, and trapezius muscles was registered through surface electromyography.

Result
In the cut task, the degree of muscle activity was lower in conventional laparoscopy, but with significant differences only in the trapezius muscle (LAP 7.27±3.56 vs. LESS 13.41±3.78;S During the coordination exercise, LESS also seem to entail greater muscle activity but without any significant statistical differences.

Conclusion
LESS surgery implies greater level of muscle activity in the trapezius muscle when we compare it with traditional laparoscopy. By analysing these results together with others obtained in similar studies of our group, we can also conclude that the use of one straight and one articulated instrument during LESS surgery correlates with better ergonomics compared with the use of two articulated instruments.