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中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (05) : 317 -320. doi: 10.3877/cma.j.issn.1674-6899.2019.05.014

所属专题: 文献

综述

胸腔镜人体工学研究现状
张霖1, 耿庆1,(), 范涛1, 郭小波1, 李东航1   
  1. 1. 430060 武汉大学人民医院胸外科
  • 收稿日期:2019-07-03 出版日期:2019-10-30
  • 通信作者: 耿庆

The current status of ergonomics in thoracoscopy and its improvement

Lin Zhang1, Qing Geng1,(), Tao Fan1, Xiaobo Guo1, Donghang Li1   

  1. 1. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
  • Received:2019-07-03 Published:2019-10-30
  • Corresponding author: Qing Geng
  • About author:
    Corresponding author: Geng Qing, Email:
引用本文:

张霖, 耿庆, 范涛, 郭小波, 李东航. 胸腔镜人体工学研究现状[J/OL]. 中华腔镜外科杂志(电子版), 2019, 12(05): 317-320.

Lin Zhang, Qing Geng, Tao Fan, Xiaobo Guo, Donghang Li. The current status of ergonomics in thoracoscopy and its improvement[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(05): 317-320.

胸腔镜手术是一种微创外科手术,与传统开胸手术相比,胸腔镜手术可以给患者带来更小的创伤、更小的肺功能影响、更低的围手术期病死率及更轻的术后疼痛。人体工学是研究工作者与工作环境相互作用的科学。在让患者获益的同时,胸腔镜手术会给医师带来许多人体工学方面的问题。在进行手术时,手术设备的不正确摆放、不正确的手术姿势和不合理的器械设计都会对医师的身体造成额外的负担,引起职业病。笔者通过检索文献和专利,在此就胸腔镜手术中遇到的问题及解决方法予以综述,并对器械的革新进行展望,希望能减少微创手术给胸外科医师带来的身体损害,并为将来的研究提供思路和方向。

Thoracoscopy is one kind of the minimal invasive surgery and is developing quickly in recent years.Comparing to traditional open surgery, thoracoscopy brings less surgical trauma, lower mortality rates, and shorter hospital stay. Ergonomics is a science focusing on the interactions between the worker and the environment. While thoracoscopy benefits patients, it brings unnegligible damage and burden to doctor's physical health. Inappropriate set of instruments, incorrect surgery postures and unsuitable instrumental design brings extra burden to the surgeons. Here we make a review of related literatures to investigate the current ergonomic status in thoracoscopy. This review summerizes the ergonomic problems during thoracoscopy, exhibites the solutions and innovations, aiming to solve the current ergonomic problems and provide directions for future research.

1
Welcker K, Kesieme EB, Internullo E, et al. Ergonomics in thoracoscopic surgery: results of a survey among thoracic surgeons[J]. Interactive CardioVascular and Thoracic Surgery,2012,15(2): 197-200.
2
Yoon SH, Jung MC, Park SY. Evaluation of surgeon′s muscle fatigue during thoracoscopic pulmonary lobectomy using interoperative surface electromyography[J]. J Thorac Dis,2016,8(6): 1162-1169.
3
Park A, Lee G, Seagull FJ, et al. Patients benefit while surgeons suffer: an impending epidemic[J]. Journal of the American College of Surgeons,2010,210(3): 306-313.
4
Wauben LSGL, Veelen MA, Gossot D, et al. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons[J]. Surgical Endoscopy And Other Interventional Techniques,2006,20(8): 1268-1274.
5
Kranenburg L, Gossot D. Ergonomic problems encountered during video-assisted thoracic surgery[J]. Minimally Invasive Therapy & Allied Technologies,2009,13(3): 147-155.
6
Choi S. A review of the ergonomic issues in the laparoscopic operating room[J]. Journal of Healthcare Engineering,2012,3(4): 587-604.
7
Veelen MA, Nederlof EAL, Goossens RHM, et al. Ergonomic problems encountered by the medical team related to products used for minimally invasive surgery[J]. Surgical Endoscopy,2003,17(7): 1077-1081.
8
Lucas-Hernandez M, Pagador JB, Perez-Duarte FJ, et al. Ergonomics problems due to the use and design of dissector and needle holder: a survey in minimally invasive surgery[J]. Surg Laparosc Endosc Percutan Tech,2014,24(5): 170-177.
9
Veelen MA, Jakimowicz JJ, Kazemier G. Improved physical ergonomics of laparoscopic surgery[J]. Minimally Invasive Therapy & Allied Technologies,2009,13(3): 161-166.
10
Veelen MA, Kazemier G, Koopman J, et al. Assessment of the ergonomically optimal operating surface height for laparoscopic surgery[J]. J Laparoendosc Adv Surg Tech A,2002,12(1): 47-52.
11
Matern U. Ergonomic deficiencies in the operating room: examples from minimally invasive surgery[J]. Work,2009,33(2): 165-168.
12
Veelen MA, Jakimowicz JJ, Goossens RHM, et al. Evaluation of the usability of two types of image display systems, during laparoscopy[J]. Surgical Endoscopy,2002,16(4): 674-678.
13
Zehetner J, Kaltenbacher A, Wayand W, et al. Screen height as an ergonomic factor in laparoscopic surgery[J]. Surgical Endoscopy,2006,20(1): 139-141.
14
Det MJ, Meijerink WJHJ, Hoff C, et al. Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines[J]. Surgical Endoscopy,2009,23(6): 1279-1285.
15
Uhrich ML, Underwood RA, Standeven JW, et al. Assessment of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery[J]. Surgical Endoscopy,2002,16(4): 635-639.
16
Berguer R, Hreljac A. The relationship between hand size and difficulty using surgical instruments: a survey of 726 laparoscopic surgeons[J]. Surgical Endoscopy,2004,18(3): 508-512.
17
Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy[J]. Interactive CardioVascular and Thoracic Surgery,2011,12(3): 539-539.
18
Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer[J]. Ann Cardiothorac Surg,2016,5(2): 76-84.
19
Bertolaccini L, Rocco G, Viti A, et al. Geometrical characteristics of uniportal VATS[J]. J Thorac Dis,2013,5(3): 214-216.
20
Bertolaccini L, Viti A, Terzi A. Ergon-trial: ergonomic evaluation of single-port access versus three-port access video-assisted thoracic surgery[J]. Surgical Endoscopy,2015,29(10): 2934-2940.
21
Bertolaccini L, Rocco G, Pardolesi A, et al. The geometric and ergonomic appeal of uniportal video-assisted thoracic surgery[J]. Thoracic Surgery Clinics,2017,27(4): 331-338.
22
Yeung C, Gilbert S. The state of uniportal video-assisted thoracoscopic surgery in north america: a survey of thoracic surgeons[J]. Journal of visualized surgery, 2018,4(1): 19-20.
23
Gao T, Xiang J, Jin R, et al. "Ipsilateral, high, single-hand, sideways" -ruijin rule for camera assistant in uniportal video-assisted thoracoscopic surgery[J]. J Thorac Dis,2016,8(10): 2952-2955.
24
Cuschieri A, Shimi S, Banting S. Endoscopic oesophagectomy through a right thoracoscopic approach[J]. J R Coll Surg Edinb,1992,37(1): 7-11.
25
Cuschieri A. Thoracoscopic subtotal oesophagectomy[J]. Endoscopic surgery and allied technologies,1994,2(1): 21-22.
26
孙超,石维平,吕小夏,等. 胸腔镜食管癌手术上纵隔缝合方法及经验总结[J/CD]. 中华腔镜外科杂志(电子版),2017,10(4): 226-229.
27
Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position-experience of 130 patients[J]. Journal of the American College of Surgeons,2006,203(1): 7-16.
28
Koyanagi K, Ozawa S, Tachimori Y. Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review[J]. Surgery Today,2016,46(3): 275-284.
29
Dapri G, Himpens J, Ntounda R, et al. Enucleation of a leiomyoma of the mid-esophagus through a right thoracoscopy with the patient in prone position[J]. Surgical Endoscopy,2010,24(1): 215-218.
30
Jarral OA, Purkayastha S, Athanasiou T, et al. Thoracoscopic esophagectomy in the prone position[J]. Surgical Endoscopy,2012,26(8): 2095-2103.
31
Shen Y, Feng M, Tan L, et al. Thoracoscopic esophagectomy in prone versus decubitus position: ergonomic evaluation from a randomized and controlled study[J]. The Annals of Thoracic Surgery,2014,98(3): 1072-1078.
32
Reyes DAG, Tang B, Cuschieri A. Minimal access surgery (MAS)-related surgeon morbidity syndromes[J]. Surgical Endoscopy,2006,20(1): 1-13.
33
Steinhilber B, Hoffmann S, Karlovic K, et al. Development of an arm support system to improve ergonomics in laparoscopic surgery: study design and provisional results[J]. Surgical Endoscopy,2015,29(9): 2851-2858.
34
Liu S, Hemming D, Luo RB, et al. Solving the surgeon ergonomic crisis with surgical exosuit[J]. Surgical Endoscopy,2018,32(1): 236-244.
35
Veelen MA, Snijders CJ, Leeuwen E, et al. Improvement of foot pedals used during surgery based on new ergonomic guidelines[J]. Surgical Endoscopy,2003,17(7): 1086-1091.
36
Choi S. A review of the ergonomic issues in the laparoscopic operating room[J]. Journal of Healthcare Engineering,2012,3(4): 587-604.
37
吴汉然,李彩伟,熊燃,等. 单孔胸腔镜肺部手术淋巴结清扫范围及中转率分析[J]. 中华胸心血管外科杂志,2018,34(9): 513-517.
38
罗洞波,吴振华,孙晓宏,等. 侧俯卧位同左侧卧位胸腹腔镜食管癌根治术的临床比较[J]. 中国医药导刊,2016,18(12): 1191-1192.
39
Li X, Lai FC, Qiu ML, et al. Minimally invasive esophagectomy in the lateral-prone position: experience of 226 cases[J]. Surg Laparosc Endosc Percutan Tech,2016,26(1): 60-65.
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