基于人因工程评价系统对经脐入路腹腔镜手术可转向器械的评估  

Evaluation of articulated instruments for transumbilical laparoscopic surgery by using ergonomics evaluation system

作　　者：陆佳军 徐安安[2] 黄瑞[2] 彭建佩 朱江帆[2] 

机构地区：[1]嘉兴市第一医院,浙江嘉兴314000 [2]同济大学附属东方医院

出　　处：《腹腔镜外科杂志》2017年第3期197-200,共4页Journal of Laparoscopic Surgery

摘　　要：目的:评估经脐入路腹腔镜手术(transumbilical endoscopic surgery,TUES)中的可转向器械。方法:使用SILS Port、腹腔镜模拟训练箱及压力传感系统建立基于人因工程评价系统的TUES测试平台。分别在传统直器械平行操作组(A组)、可转向器械平行操作组(B组)及可转向器械交叉操作组(C组)进行穿孔与打结实验。每组分别完成穿孔与打结实验各10次。用压力传感系统采集数据,将采集所得数据进行分析比较。结果:穿孔实验中,三组操作拇指掌侧面总体压力差异有统计学意义(P<0.05),且两两相比差异均有统计学意义(P<0.05),A组压力最大,B组次之,C组最小;三组操作环指掌侧面总体压力间差异有统计学意义(P<0.05),但A组、B组间差异无统计学意义(P=0.218)。打结实验中,三组操作拇指掌侧面、环指掌侧面总体压力差异均有统计学意义(P<0.05);A组拇指与无名指掌侧压力最大,C组次之,B组最小。结论:与传统直器械相比,TUES术中应用可转向器械可有效减少术者术中的疲劳程度、提高手术舒适度;进行不同难易程度操作时,需要合理选择不同可转向器械操作方式,以达到省力的目的。Objective：To evaluate the articulated instruments for transumbilical laparoscopic surgery （TUES）.Methods：A TUES measurement system,which was composed of a SILS Port,a laparoscopic training simulator and a pressure sensing system based on ergonomics,was set up to investigate the performance of two tasks （suture pass-through rings and knot-tying） in three groups：uncrossed manipulation with straight instruments （group A）,uncrossed manipulation with articulated instruments （group B） and cross-handed manipulation with articulated instruments （group C）.In each group,the corresponding instrument was used to complete the two tasks 10 times,and pressure sensing system was used to collect data for analysis and comparison.Results：In the suture pass-through rings task,the three groups demonstrated significant difference in the overall mean pressure of the palm side of the thumb （P〈0.05）.The pairwise comparisons also showed significant difference （P〈0.05）.Group A had the highest mean pressure,then was group B,group C had the lowest one.Besides,the three groups showed significant difference in the overall mean pressure of the palm side of the ring finger （P〈0.05）,the pairwise comparisons also showed significant difference except group A vs.group B （P=0.218）.In the knot-tying task,the overall mean pressure of the palm side of the thumb and ring finger in the three groups was statistically different （P〈0.05）.Group A had the highest mean pressure,then was group C,group B had the lowest one.Conclusions：Compared with straight instruments,articulated instruments perform better in reducing the degree of fatigue and improving the degree of comfort.The choice of operating modes of articulated instruments should depend on the degree of operative difficulties in TUES.

关 键 词：腹腔镜检查 经脐入路 人因工程学 可转向器械 

分 类 号：R656[医药卫生—外科学]