内镜下二外科四手前颅底手术的手术设置对外科医生工效学的影响。

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of neurosurgical sciences Pub Date : 2024-12-01 Epub Date: 2023-05-09 DOI:10.23736/S0390-5616.23.05991-X
Pavithran Maniam, James Lucocq, Rohit Gohil, Ashok Rokade
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引用次数: 0

摘要

背景:内镜下两外科四手前颅底手术的不同手术设置对外科医生工效学的影响尚不清楚。本研究旨在利用快速全身评估(REBA)工具探讨外科医生、患者和手术屏幕位置对外科医生人体工程学的影响。方法:采用经过验证的快速全身评估(REBA)工具,模拟前颅底手术的20种不同手术体位,测量手术者颈部、卡车、腿部和手腕的人体工程学影响。为了研究不同手术姿势对人体工程学的影响,在每个手术姿势中,术者、辅助术者、患者头部、摄像机和屏幕的位置都不同。结果:REBA评分最低为3分,最高为8分。大多数位置的REBA分数为3,突出表明这些位置符合人体工程学。体位12是最不符合人体工程学的体位,REBA总分为19分。在该体位中,手术医生位于患者的右侧,辅助医生位于患者的左侧,患者头部处于中心位置,由手术医生手持摄像机,在患者的右侧放置一个屏幕。位置13和17是最符合人体工程学的位置,REBA总分为12分。在这些体位中,患者的头部位于中心,使用两个屏幕,外科医生位于患者的两侧。在患者头部中心位置使用2个屏幕,外科医生放置在患者的两侧,这些位置有助于更符合人体工程学的状态。结论:与其他体位行为相比,某些体位行为能更好地降低肌肉骨骼损伤风险。两个屏幕和头部中心位置的位置更符合人体工程学,外科医生应该考虑这种设置,以减少前颅底手术时肌肉骨骼的损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of surgical set-up of endoscopic two surgeon four hand anterior skull base surgeries on surgeons' ergonomics.

Background: The impact of different surgical set-ups of endoscopic two surgeon four hand anterior skull base surgeries on surgeons' ergonomics remain unclear. This study aims to explore the effect of surgeon, patient and surgical screen positioning on surgeons' ergonomics using the Rapid Entire Body Assessment (REBA) tool.

Methods: A total of 20 different surgical positions of anterior skull base surgery were simulated and the ergonomic impact on surgeons' neck, truck, leg and wrist were measured using the validated Rapid Entire Body Assessment (REBA) tool. To investigate the ergonomic effect of different surgical setups, the operating surgeon, assisting surgeon, patient head, camera and screen positions were positioned differently in each surgical position.

Results: The lowest REBA Score recorded is 3 whereas the highest score is 8. The REBA scores for the majority of positions are 3 highlighting that these positions are ergonomically favorable. Position 12 is the least ergonomically favorable position with a total REBA score of 19. In this position, operating surgeon is positioned to the right of the patient, assisting surgeon to the left of patient, patient head in central position with camera held by operating surgeon and one screen is placed to the right of patient. Positions 13 and 17 are the most ergonomically favorable positions with a total REBA score of 12. In these positions, the patient's head is positioned to the center, two screens were utilized, and the surgeons were positioned on either side of the patient. The utilization of 2 screens with a central patient head position with the surgeons placed on either side of the patient contribute towards a more ergonomically state in these positions.

Conclusions: Certain positional behaviors are better at reducing musculoskeletal injury risk when compared to other. Positions with two screens and central head positions are more favourable ergonomically and surgeons should consider this set-up to reduce musculoskeletal injuries during anterior skull base surgery.

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来源期刊
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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