title: An innovative device for creating tissue plane cleavage by hydro-dissection based on lever and ergonomic principle.
abstract: In the Third world countries, the occupational health of a Reconstructive Surgeon attracts due attention from the applied physiology fraternity, where the massive amount of surgical workload causes chronic fatigue and repeated stress and injury. The knowledge of human physiology and the science of ergonomics analyze these challenges and formulate guidelines for creating a work environment that is safe and comfortable for its operators. Presented here is an innovative, cost effective, sterilizable, manually controlled hydrodissection instrument for surgery. This easy to make Syringe Pressure Gun (SPG), has revolutionized the face of cleft palate surgery reducing the surgical time to 50% and the palatal fistula rate from 3% to Zero percent. The effects were studied on patients and the operating surgeon both. The experimental group comprising of 1500 cleft palate patients in whom the gun was used during surgery as compared to 500 controls showed statistically highly significant results in terms of reduction in average bleeding in millilitres (P<0.05), average operating time in minutes (P<0.001), palatal fistula formation (P<0.005) and reduction in surgical complications like flap necrosis. The results in the operating surgeon (self control) on using the instrument, showed highly statistically significant fall in the muscle strain induced by tedious surgical manoeuvres, as studied by EMG (P<0.005), subjective hand grip pain and tiredness on a scale of 0-10, high convenience in flap dissection and therefore work performance improved in spite of the high volume of surgery. This ergonomic innovation will provide clues for future inventions based on physiological principles for improving the occupational health of the doctors and outcome of the patients.
authors.affiliation: Department of Physiology, Himalayan Institute of Medical Sciences Jolly Grant, Dehradun - 248 140 India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Dvivedi
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dvivedi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D004576:Electromyography; D006804:Ergonomics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013525:Surgical Instruments