title: Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy.
abstract: BACKGROUND
  With the expanding implementation of minimally invasive surgery, the operating team is confronted with challenges in the field of ergonomics. Visual feedback is derived from a monitor placed outside the operating field. This crossover trial was conducted to evaluate and compare neck posture in relation to monitor position in a dedicated minimally invasive surgery (MIS) suite and a conventional operating room.
  
  
  METHODS
  Assessment of the neck was conducted for 16 surgeons, assisting surgeons, and scrub nurses performing a laparoscopic cholecystectomy in both types of operating room. Flexion and rotation of the cervical spine were measured intraoperatively using a video analysis system. A two-question visual analog scale (VAS) questionnaire was used to evaluate posture in relation to the monitor position.
  
  
  RESULTS
  Neck rotation was significantly reduced in the MIS suite for the surgeon (p = 0.018) and the assisting surgeon (p < 0.001). Neck flexion was significantly improved in the MIS suite for the surgeon (p < 0.001) and the scrub nurse (p = 0.018). On the questionnaire, the operating room team scored their posture significantly higher in the MIS suite and also indicated fewer musculoskeletal complaints.
  
  
  CONCLUSIONS
  The ergonomic quality of the neck posture is significantly improved in the MIS suite for the entire operating room team.
authors.affiliation: Department of Surgery, Leeuwarden Medical Center, P.O. Box 888, 8901 BR, Leeuwarden, The Netherlands. marc.van.det@znb.nl
authors.forename: M J
authors.initials: MJ
authors.lastname: van Det
authors.forename: W J H J
authors.initials: WJ
authors.lastname: Meijerink
authors.forename: C
authors.initials: C
authors.lastname: Hoff
authors.forename: M A
authors.initials: MA
authors.lastname: van Veelen
authors.forename: J P E N
authors.initials: JP
authors.lastname: Pierie
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D018592:Cross-Over Studies; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck / Q000502:physiology*; D009873:Operating Rooms; D011187:Posture / Q000502:physiology*; D012399:Rotation; D011795:Surveys and Questionnaires; D014741:Video Recording