بهبود وضعیت ارگونومیک در اتاق عمل یکپارچه برای انجام عملیات لاپاروسکوپی

The aim of our work is to reduce the stress and strain for the medical staff and simultaneously to increase the efficiency and safety of an integrated operating room system (SIOS) by an ergonomic redesign of the system. SIOS system is a central control system developed by Siemens Medical Solutions mainly used for laparoscopic operations. This new integrated system has been created to improve the efficiency in operating rooms (ORs). The interactive manner of control of nearly all parameters, like the position of the OR table or the intensity of the light, is the main difference of the integrated OR system SIOS compared with conventional operating rooms. However, considering the postures of the doctors and the nurse, the operating room is still a very uncomfortable place of work. To make an ergonomic approach, many factors like human capabilities, functions, anthropometrics, psychological, and physical ones have been taken into account. We performed an ergonomic analysis and propose a new ergonomic redesign.

Minimally invasive surgery, or minor access surgery, is a new surgical approach avoiding large incisions for intrabdominal operations as required in conventional (open) surgery. This is achieved by introducing three or more trocars (ports) into the abdominal cavity which permit the introduction of a camera-monitored telescope and two or more fine instruments to perform the operation in a similar manner as, formal, in open surgery. This new approach requires, in comparison to open surgery, an additional spectrum of devices and technical support (lights sources, camera, control unit, insulator, video screens, etc). In standard operating rooms (ORs), this additional equipment is positioned upon special trolleys. A top of these trolleys, the monitor/video screens is positioned. In most of the cases, it is not easy to find an “ideal” position for the trolley/monitor. A compromise between the ‘ideal’ position and the available space is inevitable [1], [2] and [3].

By the diagonal arrangement of the surgeon screens, he (or she) does not have to turn his neck from the patient. The monitor for the nurse and the assistant should be in front of them. Another important parameter is the height of the operating table. According to this study, it is obvious that is very difficult to choose an optimal position for each member of the team. With the actual operating theatre, the solution for this problem would be reached as a compromise between the different body heights of the medical staff by using steps. A possible solution for the future operating room would be to install an electrical step in each one of the positions. These steps would be integrated in the floor of the operating room. In this way, these steps would be controlled with the integrated OR systems (SIOS) and they could be moved quickly and safely.