title: A feasibility study determining surgical ergonomics in a live surgical setting.
abstract: OBJECTIVE
  To identify the biomechanical movements of laparoscopic surgeons during laparoscopic gynecologic procedures, and to determine whether such movements can be assessed and measured both temporally and biomechanically.
  
  
  METHODS
  Prospective descriptive kinematic study (Canadian Task Force classification II-3).
  
  
  METHODS
  A tertiary referral hospital in Sydney, Australia.
  
  
  METHODS
  Five gynecologic laparoscopic surgeons.
  
  
  METHODS
  Video recording from a variety of fixed positions to assess surgeon stance, time spent in specific postures, and relative change of limb angles during laparoscopic surgical procedures.
  
  
  RESULTS
  Postoperative review of surgical movements during laparoscopic surgery was able to provide quantitative data. Motion and timing could be classified by angle banding ranges among surgeons. The most extreme shoulder abduction angles occurred during trocar insertion (61°) and insertion or removal of laparoscopic instruments (63.5°), with procedures involving morcellation requiring the greatest number of instrument insertions or removals (n = 57). The elbow is most frequently in a neutral position in TLH, and the shoulder spends the most time in abduction during myomectomy.
  
  
  CONCLUSIONS
  This proof-of-concept study confirms that detailed ergonomic assessment is possible within live surgical settings, with identified limitations. This study may allow for a larger-scale study to determine at-risk movements during the various phases of a laparoscopic surgery and possibly control for some of these hazardous behaviors.
authors: School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors: Lucy Ping
authors: LP
authors: Aitchison
authors: School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors: James
authors: J
authors: Flint
authors: School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors: Erin
authors: E
authors: Nesbitt-Hawes
authors: School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors: William
authors: W
authors: Ledger
authors: School of Women's and Children's Health, University of New South Wales, Sydney, Australia. Electronic address: j.abbott@unsw.edu.au.
authors: Jason
authors: J
authors: Abbott
mesh_terms: D001315:Australia; D006804:Ergonomics / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies
keywords: Gynecologic laparoscopy; Surgical ergonomics; Workplace injuries