CHANGING IN THE LAP SETUP

CHANGING IN THE LAP SETUP; YOU DO NOT NEED A ROBOT FOR HAVING A GOOD ERGONOMIC POSITION, JUST TAKE A CHAIR

.Moshe Dudai MD FACS; Hernia Excellence, Tel Aviv Israel

While Laparoscopy took its early steps in the 90th, one of the main objectives was convincing the traditional surgery community that we are not changing the surgical tradition, but doing the same surgery using the Lap technology for regaining less surgical trauma. For this reason, the surgeon continues standing up beside of the patient during the surgery, performing the Lap surgery mostly in unbelievable unacceptable position of hands, shoulders, neck and head, lumbar spine and legs. More than 85% of the Lap surgeons suffered from Lap working injuries. No one of us thought that a good general surgeon can site during a surgery and the decree of the Lap position is uninventable and must be accepted. In true, the only one reason way a surgeon must stand up in a traditional open surgery, is that we are looking from up down for the pathology.

Robotic surgery took away the surgeon from the patient, for doing that he was in a situation of taking a chair for controlling the robot. This was leading to much better and rational ergonomic position for the surgeon. This argument was lastly one of the major arguments for convincing general surgeon moving towered robotic surgery for standard surgery, like Lap Hernia. In the last San Diego ACS meeting, hands voting demonstrate that finally Lap hernia move up from 30% to 50%, but this increase was because the extra new 20% are rTAPP procedures! So, finally legitimacy a general surgeon can have a chair during his surgery. By that we can save our body from the sever Lap working injuries. But, way we must pay 3.5MUS$ for achieving that, its not simpler just to take a Chair? Yes, it is!

Since early-2017 we started looking for a new Lap operating table setup with a Chair for the surgeon. In the end setup, all the surgical team are sitting on chairs, anesthetist always was… For the Lap Siting Position (LSP), we use varieties of table positioning and combinations: Low height, Trendelenburg and anti-Trendelenburg, lateral tilts, lithotomy… The trocars are inserting in standup position. After some period of adapting and learning, each of the positions for the different surgeries, we were able to achieve good ergonomic position in harmony for all body parts; neck, shoulders, hands, lumbar-spine and legs. With time we realized that we have other advantages: the general environment in the OR become calmer and the OR time become some shorter.

After 29 years of Lap surgery, breaking through tradition concepts, we took a Chair and make the Lap Surgery, LSP Ergonomic, ease and time saving.

Write a comment

דילוג לתוכן