title: Prospective randomized evaluation of gel mat foot pads in the endoscopic suite.
abstract: OBJECTIVE
  Several studies that compare open and laparoscopic procedures have demonstrated that the minimally invasive surgeon has greater musculoskeletal pain when compared with open surgeons. The purpose of our study was to demonstrate whether the use of the gel mat in the endoscopic setting offered any ergonomic benefit to the surgeon.
  
  
  METHODS
  One hundred endoscopic procedures, by 11 different surgeons, were randomized intostudy (use of a gel mat) and control groups. Procedures included both percutaneous nephrolithotomies and ureteroscopies and were randomized without regard to the type or expected length of the procedure. All subjects completed a preoperative, intraoperative, immediate postoperative, and 24-hour postoperative questionnaire. During the procedures, an independent observer recorded the number of intraoperative stretches and positional changes because of discomfort.
  
  
  RESULTS
  The mean preoperative metrics for the gel mat and no gel mat groups were similar with the exception of the ≤60-minute group, whose members found the gel mat group starting with greater overall discomfort (1.7 vs 1.3, P=0.0273). In the ≤60 minute group, gel mat use significantly decreased postoperative discomfort (P=0.0435) and improved postoperative energy (P=0.0411). In those procedures >60 minutes, the gel mat improved postoperative discomfort and energy as well as the number of stretches and postural changes during the procedure.
  
  
  CONCLUSIONS
  Application of gel mats in the endoscopic setting improves surgeon overall postoperative discomfort and energy in all cases. For cases >60 minutes duration, gel mats also decrease the number of stretches and postural changes from discomfort. Some of these salutary effects may translate into more efficient surgery and better patient outcomes.
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, New York 10032, USA. joseph.graversen@gmail.com
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Graversen
authors.forename: Ruslan
authors.initials: R
authors.lastname: Korets
authors.forename: Adam C
authors.initials: AC
authors.lastname: Mues
authors.forename: Hiroshi K
authors.initials: HK
authors.lastname: Katsumi
authors.forename: Ketan K
authors.initials: KK
authors.lastname: Badani
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
authors.forename: Mantu
authors.initials: M
authors.lastname: Gupta
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006804:Ergonomics / Q000295:instrumentation*; D005782:Gels; D006801:Humans; D011446:Prospective Studies
chemical_list: D005782:Gels