Background: Ergonomics in laparoscopy involve some terms as manipulation angle, Azimuth angle, elevation angle, and eye target axis. These parameters are determined after distribution of ports in relation to target organ. Laparoscopic appendectomy doesn't have a standard approach. Many variations are available in port placement and mostly dependent on surgeon's preference. Different port distribution will result in different ergonomics that will positively or negatively affect the task performance.
Objective: The aim of this study was to evaluate the ergonomics in laparoscopic appendectomy technique in terms of working angle, elevation angle, Azimuth angle and eye- hand- target axis.
Patients and Methods: This retrospective study included 55 consecutive patients presented with acute appendicitis who were eligible for laparoscopic appendectomy. Azimuth angle and elevation angles were measured intraoperatively, while images captured from video records of each operation were used to measure manipulation angles. Surgical team discomfort or complaint also had been reported.
Results: In this described technique, manipulation angle was 61 ± 8.3°, elevation angles were 38.9 ± 7° and 34 ± 7°, Azimuth angles were 21.3 ± 5.4° and 63.1 ± 7.3° for right and left surgeon's hand respectively. Operative time was 33.5 ± 9.7 minutes. Smooth performance was achieved in 94.5%.
Conclusion: Surgeons' orientation of ergonomic rules is a must to accomplish a smooth laparoscopic task performance. This proposed technique of laparoscopic appendectomy offers a good ergonomics and excellent cosmetic results.