Kinematical analysis of the trunk, upper limbs and fingers during minimal access surgery when using an armrest

Abstract

This study investigated whether using an armrest could reduce the movements of the trunk, upper limb and hand of surgeons during simulated minimal access surgery. Sixteen surgeons carried out two trials of simulated laparoscopic surgery, one using an armrest and the other without. Reflective markers were attached on the trunk, upper limbs, fingers, minimal access camera (MAC) and scissors, allowing a motion capture system to record the movements. The error ratios during operation, subjective opinions and operative durations were collected. The results showed that total displacements at the trunk and shoulders were reduced by at least 25% when using an armrest compared with not using one; error ratios were reduced by 7%; velocity and acceleration in the trunk, shoulder and MAC were reduced. After simulated operations, 78% of the participants preferred using the armrest. The study indicates that an armrest could improve surgical outcomes by reducing trunk movements.

Abstract

Practitioner Summary

• An armrest may help surgeons to reduce unnecessary movements during operations.

• The error ratios were reduced by 7% when using an armrest compared with no armrest.

• Displacements at the trunk and shoulders were reduced by 25% when using an armrest.

• Seventy-eight per cent of participants preferred to use an armrest after the experiment.

Keywords:

• armrest
• minimal access surgery
• kinematics

Acknowledgements

The authors thank Mr Sadiq Nasir for his technical support in data collection, and Mr Ian Christie for editing the manuscript in English. WW is grateful to the reviewers for providing constructive comments during reviewing.

Disclosure statement

Mr. Jafri, Dr. Arnold, Professor Abboud, and Dr Wang have no conflicts of interest or financial ties to disclose. Dr Brown is a named co-inventor of the surgical armrest product.

Additional information

Funding

This study was partially supported by the funds of the Joint Project of Royal Society of Edinburgh and National Natural Science Foundation of China, the Knowledge Economy Partnerships Pakistan-UK (KEP-058) of the British Council and MINISTERIO DE CIENCIA E INNOVACIÓN CGL2010-20868 of Spain.