Last month, we talked about the best position for the video monitor. Now let’s talk about the best position for the surgeon and assistant. With the advent of robotic surgery, the surgical team will often sit, rather than stand. Although sitting will give the feet and legs some relief, it will restrict the motion of the upper body. As a result, the arms and head will often travel to the extremes of their range-of-motion. Here are some recommendations to limit this risk:
- Proper monitor height and position, as discussed last month.
- Place a padded instrument stand over the patient such that the table-side assistant can rest their highest elbow while holding an instrument.
- Adjust stool height of assistant (and table height of patient) such that the assistant’s lowest arm can rest by their side (upper arm perpendicular to floor, forearm parallel to floor).
- Place a blanket on the floor underneath the rolling chair of the surgeon at the robotic control console. Without this maneuver, as the surgeon tends to lean slightly forward, the chair will tend to drift backward. As a result, the lower back will strain to resist this tendency. The blanket will provide enough resistance to prevent unintentional movement yet still allow fine-tuning of position by the surgeon.
We are always taught “first do no harm.” I feel this also applies to the surgeon and surgical team. Operating teams that have visited our hospital consistently comment on the value of these ergonomic tips.