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Ergonomic assessment of the French and American position for laparoscopic cholecystectomy in the MIS suite

机译：MIS套件中法国和美国对腹腔镜胆囊切除术位置的人体工程学评估

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Background: Cholecystectomy was one of the first surgical procedures to be performed with laparoscopy in the 1980s. Currently, two operation setups generally are used to perform a laparoscopic cholecystectomy: the French and the American position. In the French position, the patient lies in the lithotomy position, whereas in the American position, the patient lies supine with the left arm in abduction. To find an ergonomic difference between the two operation setups the movements of the surgeon's vertebral column were analyzed in a crossover study. Methods: The posture of the surgeon's vertebral column was recorded intraoperatively using an electromagnetic motion-tracking system with three sensors attached to the head and to the trunk at the levels of Th1 and S1. A three-dimensional posture analysis of the cervical and thoracolumbar spine was performed to evaluate four surgeons removing a gallbladder in the French and American position. The body angles assessed were flexion/extension of the cervical and thoracolumbar spine, axial rotation of the cervical and thoracolumbar spine, lateroflexion of the cervical and thoracolumbar spine, and the orientation of the head in the sagittal plane. For each body angle, the mean, the percentage of operation time within an ergonomic acceptable range, and the relative frequencies were calculated and compared. Results: No statistical difference was observed in the mean body angles or in the percentages of operation time within an acceptable range between the French and the American position. The relative frequencies of the body angles might indicate a trend toward slight thoracolumbar flexion in the French position. Conclusion: In a modern dedicated minimally invasive surgery suite, the body posture of the neck and trunk and the orientation of the head did not differ significantly between the French and American position.
机译：背景：胆囊切除术是1980年代首批通过腹腔镜进行的外科手术之一。当前，通常使用两种手术装置进行腹腔镜胆囊切除术：法国和美国。在法国位置，患者处于截石术位置，而在美国位置，患者仰卧，左臂被绑架。为了在两种手术设置之间找到符合人体工程学的差异，在交叉研究中分析了外科医生椎骨的运动。方法：使用电磁运动跟踪系统在术中记录外科医生椎骨的姿势，该系统在Th1和S1的水平上将三个传感器连接到头部和躯干。对颈椎和胸腰椎进行了三维姿势分析，以评估四名外科医生在法国和美国的位置摘除胆囊。评估的体角为颈椎和胸腰椎脊柱的屈伸/伸展，颈椎和胸腰椎脊柱的轴向旋转，颈椎和胸腰椎脊柱的后屈以及头部在矢状面内的方向。计算并比较每个体角的平均值，人体工程学可接受范围内的手术时间百分比以及相对频率。结果：在法国和美国位置之间的可接受范围内，平均体角或手术时间百分比均未观察到统计学差异。体角的相对频率可能表明在法国姿势下胸腰椎有轻微弯曲的趋势。结论：在现代专用微创手术室中，法国和美国的位置之间颈部和躯干的身体姿势以及头部的朝向没有显着差异。

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