{"title":"Force application of laparoscopic surgeons under the impact of heavy personal protective equipment during COVID-19 pandemic","authors":"Yao Zhang, Shuyi (Kiana) Wang, Bin Zheng","doi":"10.1016/j.lers.2022.05.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Surgeons are required to wear heavy personal protective equipment while delivering care to patients during the COVID-19 pandemic. We examined the impact of wearing double gloves on surgeons’ performance in laparoscopic surgery.</p></div><div><h3>Methods</h3><p>Eleven surgeons-in-training at the Surgical Simulation Research Lab of the University of Alberta were recruited to perform laparoscopic cutting tasks in simulation while wearing none, one pair, and two pairs of surgical gloves. Forces applied to laparoscopic instruments were measured.</p></div><div><h3>Results</h3><p>Wearing gloves prolonged task times (one pair of gloves: 301.6 ± 61.7 s; two pairs of gloves: 295.8 ± 65.3 s) compared with no gloves (241.7 ± 46.9 s; <em>p =</em> 0.043). Wearing double gloves increased cutting errors (20.4 ± 5.1 mm<sup>2</sup>) compared with wearing one pair of gloves (16.9 ± 5.5 mm<sup>2</sup>) and no gloves (14.4 ± 4.6 mm<sup>2</sup>; <em>p =</em> 0.030). Wearing gloves reduced the peak force (one pair of gloves: 2.4 ± 0.7 N; two pairs of gloves: 2.7 ± 0.6 N; no gloves: 3.4 ± 1.4 N; <em>p</em> = 0.049), and the total force (one pair of gloves: 10.1 ± 2.8 N; two pairs of gloves: 10.3 ± 2.6 N; no glove: 12.6 ± 1.9 N; <em>p</em> = 0.048) delivered onto laparoscopic scissors compared with wearing no glove.</p></div><div><h3>Conclusion</h3><p>The combined effects of wearing heavy gloves and using tools reduced the touching sensation, which limited the surgeons’ confidence in performing surgical tasks. Increasing practice in simulation is suggested to allow surgeons to overcome difficulties brought by personal protective equipment.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"5 3","pages":"Pages 106-110"},"PeriodicalIF":0.0000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900922000287/pdfft?md5=de774a524703cec989174e968cd4a23c&pid=1-s2.0-S2468900922000287-main.pdf","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laparoscopic Endoscopic and Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468900922000287","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 2
Abstract
Objective
Surgeons are required to wear heavy personal protective equipment while delivering care to patients during the COVID-19 pandemic. We examined the impact of wearing double gloves on surgeons’ performance in laparoscopic surgery.
Methods
Eleven surgeons-in-training at the Surgical Simulation Research Lab of the University of Alberta were recruited to perform laparoscopic cutting tasks in simulation while wearing none, one pair, and two pairs of surgical gloves. Forces applied to laparoscopic instruments were measured.
Results
Wearing gloves prolonged task times (one pair of gloves: 301.6 ± 61.7 s; two pairs of gloves: 295.8 ± 65.3 s) compared with no gloves (241.7 ± 46.9 s; p = 0.043). Wearing double gloves increased cutting errors (20.4 ± 5.1 mm2) compared with wearing one pair of gloves (16.9 ± 5.5 mm2) and no gloves (14.4 ± 4.6 mm2; p = 0.030). Wearing gloves reduced the peak force (one pair of gloves: 2.4 ± 0.7 N; two pairs of gloves: 2.7 ± 0.6 N; no gloves: 3.4 ± 1.4 N; p = 0.049), and the total force (one pair of gloves: 10.1 ± 2.8 N; two pairs of gloves: 10.3 ± 2.6 N; no glove: 12.6 ± 1.9 N; p = 0.048) delivered onto laparoscopic scissors compared with wearing no glove.
Conclusion
The combined effects of wearing heavy gloves and using tools reduced the touching sensation, which limited the surgeons’ confidence in performing surgical tasks. Increasing practice in simulation is suggested to allow surgeons to overcome difficulties brought by personal protective equipment.
期刊介绍:
Laparoscopic, Endoscopic and Robotic Surgery aims to provide an academic exchange platform for minimally invasive surgery at an international level. We seek out and publish the excellent original articles, reviews and editorials as well as exciting new techniques to promote the academic development.
Topics of interests include, but are not limited to:
▪ Minimally invasive clinical research mainly in General Surgery, Thoracic Surgery, Urology, Neurosurgery, Gynecology & Obstetrics, Gastroenterology, Orthopedics, Colorectal Surgery, Otolaryngology, etc.;
▪ Basic research in minimally invasive surgery;
▪ Research of techniques and equipments in minimally invasive surgery, and application of laparoscopy, endoscopy, robot and medical imaging;
▪ Development of medical education in minimally invasive surgery.