Energy consumption during simulated minimal access surgery with and without using an armrest.
BACKGROUND
Minimal access surgery (MAS) can be a lengthy procedure when compared to open surgery and therefore surgeon fatigue becomes an important issue and surgeons may expose themselves to chronic injuries and making errors. There have been few studies on this topic and they have used only questionnaires and electromyography rather than direct measurement of energy expenditure (EE). The aim of this study was to investigate whether the use of an armrest could reduce the EE of surgeons during MAS.


METHODS
Sixteen surgeons performed simulated MAS with and without using an armrest. They were required to perform the time-consuming task of using scissors to cut a rubber glove through its top layer in a triangular fashion with the help of a laparoscopic camera. Energy consumptions were measured using the Oxycon Mobile system during all the procedures. Error rate and duration time for simulated surgery were recorded. After performing the simulated surgery, subjects scored how comfortable they felt using the armrest.


RESULTS
It was found that O(2) uptake (VO(2)) was 5 % less when surgeons used the armrest. The error rate when performing the procedure with the armrest was 35 % compared with 42.29 % without the armrest. Additionally, comfort levels with the armrest were higher than without the armrest. 75 % of surgeons indicated a preference for using the armrest during the simulated surgery.


CONCLUSIONS
The armrest provides support for surgeons and cuts energy consumption during simulated MAS.
Institute of Motion Analysis and Research, Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK. m.jafri@dundee.ac.uk
Mansoor
M
Jafri
Stuart
S
Brown
Graham
G
Arnold
Rami
R
Abboud
Weijie
W
Wang
D000328:Adult; D001291:Attitude of Health Personnel; D002245:Carbon Dioxide / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D008953:Models, Anatomic; D061646:Operative Time; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology*; D011659:Pulmonary Gas Exchange; D013523:Surgical Equipment; D011795:Surveys and Questionnaires
D002245:Carbon Dioxide; D010100:Oxygen