Improved physical ergonomics of laparoscopic surgery.

One of the main and basic ergonomic problems associated with laparoscopy is the surgeon's non-neutral posture during laparoscopic procedures. There are five main issues that influence the posture of the surgeon: the (hand-held) instrument design, the position of the monitor, the use of foot pedals to control diathermy, the poorly adjusted operating table height, and the static body posture. This paper gives an overview of the ergonomic guidelines that have been developed in these five areas and shows product solutions that have been developed according to these guidelines. The guidelines can be used by operating room (OR) staff to evaluate the ergonomics of their OR environment and to improve issues that do not satisfy the ergonomic guidelines. When designers use these guidelines to design new OR equipment, the new designs are an improvement in the field of human factors compared to the currently used laparoscopic products. When all these products are applied in the laparoscopic operating room, a new and ergonomic environment is created for the surgeon as well as for the assistants.