Ergonomics in thoracoscopic surgery: results of a survey among thoracic surgeons.

OBJECTIVES: The frequent and prolonged use of thoracoscopic equipment raises ergonomic risks which may cause physical distress. We aimed to determine the relationship between ergonomic problems encountered in thoracoscopic surgery and physical distress among thoracic surgeons. METHODS: An online questionnaire which investigated personal factors, product factors, interaction factors and physical discomfort was sent to all members of the European Society of Thoracic Surgeons (ESTS). RESULTS: Of the respondents, 2.4% indicated that a one arm's length should be the optimal distance between the surgeon and the monitor. Only 2.4% indicated that the monitor should be positioned below the eye level of the surgeon. Most of the respondents agreed, partially to fully, that they experienced neck discomfort because of inappropriate monitor height, bad monitor position and bad table height. Most respondents experienced numb fingers and shoulder discomfort due to instrument manipulation. Most of the respondents (77.1%) experienced muscle fatigue to some extent due to a static posture during thoracoscopic surgery. The majority of respondents (81.9, 76.3 and 83.2% respectively) indicated that they had varying degrees of discomfort mainly in the neck, shoulder and back. Some 94.4% of respondents were unaware of any guidelines concerning table height, monitor and instrument placement for endoscopic surgery. CONCLUSIONS: Most thoracic surgeons in Europe are unaware of ergonomic guidelines and do not practise them, hence they suffer varying degrees of physical discomfort arising from ergonomic issues.

Single-trocar-access thoracoscopy for fully optical controlled routine chest drainage: a technical report and feasibility study.

Complications of tube thoracostomy, e.g., organ lesions and malpositioned tubes, are not uncommon. To date, techniques for tube placement have been nonvisualized. The authors believe that a fully visualized penetration of the thoracic wall layers should help to avoid not only perforations and organ lesions but also functionally malpositioned tubes. This article describes a modified endoscopic device, allowing fully visualized and optically controlled access to the pleural cavity for routine chest tube placement. The results of the technical feasibility study for 28 human cadavers showed that it was possible to place the tube as desired. No organ lesions were present. The results suggest that this device and the technique could reduce the risk of complications. The handling of the device is easy and safe. The technique is minimally invasive. The authors' next goal is to prove the results in a clinical study.