Ergonomic and safety insights in minimal invasive surgery

This dissertation describes several studies that relate to the safety and ergonomics of minimally invasive surgery. The first part of this thesis describes the origin and the application of checklists in the operating room. Also, the effects of a checklist are validated and described. To reduce the number of errors, and to create as few technical and instrumental errors as possible during a procedure, a checklist is essential.

The second part of this thesis describes several research projects related to the basic ergonomics of laparoscopic and robot assisted surgical procedures. In order to improve the current sitting position in a surgical console, the console ergonomics were analysed and a special console chair was designed. Also, the disadvantages of the current console design are described and proposals for future improvements are made.

Part 3 of the thesis describes the role of robot assisted procedures in relation to ergonomics. In one of the studies, a training program was designed and tested with 26 trainees. The results show that such a training program can be very effective in improving the sitting position in the console. In chapter 9, the role of the first assistant / scrub nurse is discussed. After analysis, there was established that they suffer from high physical workload. Simple changes and advices can lead to a severe reduction in workload. Finally, this thesis describes how robotic camera holders can reduce the ergonomic impact of an operation. The first assistant can mainly benefit from such a robotic camera holder. When working with this device, the first assistant can now focus on just one task and displays a significantly lower Rapid Upper Limb Assessment (RULA) ergonomic score.