MINImalt INVASIV KIRURGI Bilde 2 og 3. Begge bildene er fra samme laparoskopiske binyreoperasjon på FOR, som er dedikert forskning og utvikling. Legg spesielt merke til høyre overarm som løftes samt instrumentet i høyre neve hvor tommelen aktiverer tuppen på instrumentet mens på bilde 2 er det pekefingeren som aktiverer instrumentet. Diatermiledningen på Volargrip tilkobles instrumentet slik at den ikke kommer i veien for kirurgens hender. beskrevet i andre studier (1.3, 6, 8, 9, 11, 13, 15, 16, 25). Det ovenfor nevnte gir oss middelaldrende kirurger mulighet til et positivt syn på fremtiden. Det er for øvrig viktig at ergo<strong>no</strong>mien i hele operasjonsstuen blir vurdert for å få en funksjonell enhet. Fremtidens operasjonsrom Før byggingen av St Olavs Hospital ble det , under ledelse av professor Hans Olav Myhre, opprettet to eksperimentelle operasjonsstuer, kalt Fremtidens Operasjonsrom (FOR). Disse hadde til hensikt å forbedre sykehusets nye operasjonsstuer og dermed minske risikoen for å bringe foreldet tankegods inn i de nye stuene. Dette har vi til en stor grad lyktes med takket være industrien, Helsebygg, NTNU og Sintef som alle har vært aktive deltagere i dette prosjektet. På bilde 3 ses den ferdige operasjonsstuen for laparoskopi ved FOR. Den er spesialdesignet for laparoskopi og avansert fleksibel endoskopi, men er også godt egnet til åpen kirurgi. Surgitech har nå utviklet et komplett sett av instrumenter, inklusive trokarer, for de vanligste laparoskopiske prosedyrene. Instrumentene har CEgodkjenning og selges allerede i flere europeiske land samt i Sør-Korea og Kina. Foreløpig er det ingen markedsføring eller forhandlere av instrumentene i Skandinavia og interesserte må derfor ta direkte kontakt med Surgitech Norway for tilbud • Referanser 1 Berguer R, Forkey DL, Smith DW (2001) The effect of laparoscopic instrument working angle on surgeons‘upper extremity workload. Surg Endosc 15:1027-1029. 2 Berguer R, Gerber S, Kilpatrick G, Remler M, Beckley D (1999) A comparison of forearm and thumb muscle electromyographic reponses to the use of laparoscopic instruments with either a finger grasp or a palm grasp. Ergo<strong>no</strong>mics 42:1634-1645. 3 Berguer R, Gerber S, Kilpatrik G, Beckley D (1998) An ergo<strong>no</strong>mic comparison of inline vs pistol-grip handle configuration in a laparoscopic grasper. Surg Endosc 12:805-808. 4 Delagi EF, Iazetti J, Perotto A, Morrison D (1989) Elektromyographie der Extremitäten Ferdinand Enke Verlag, Stuttgart. 5 Emam TA, Frank TG, Hanna GB, Cuschieri A (2001) Influence of handle design on the surgeon’s upper limb movements, muscle recruitment, and fatigue during endoscopic suturing. Surg Endosc 15(7):667-672. 6 Emam TA, Frank TG, Hanna GB, Stockham G, Cuschieri A (1999) Rocker handle for endoscopic needle drivers: technical and ergo<strong>no</strong>mic evaluation by infrared motion analysis. Surg Endosc 13(7):658-661. 7 EN IEC 62366 – Ed. 1.0 – Medical devices – Application of usability engineering to medical devices. IEC Geneva (2007) Beuth Verlag, Berlin. 8 Hanna GB, Shimi S, Cuschieri A (1997) Optimal port locations for endoscopic intracorporal k<strong>no</strong>tting. Surg Endosc 11(4):397-401. 9 Horgan LF, O'Riordan DC, Doctor N: Neurapraxia following laparoscopic procedures: an occupational hazard. 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Single-Site Instrumentation for the da Si Surgical System Vinci® • Low blood loss 1 • Fast recovery 2 • Short hospital stay 1 • Early return to daily activities 2 Single-Site Instrumentation for the da Vinci ® Si System has received CE mark and does <strong>no</strong>t have FDA clearance. 1 Curcillo PG 2nd, Wu AS, Podolsky ER, Graybeal C, Katkhouda N, Saenz A, Dunham R, Fendley S, Neff M, Copper C, Bessler M, Gumbs AA, Norton M, Iannelli A, Mason R, Moazzez A, Cohen L, Mouhlas A, Poor A. Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc. 2010 Aug;24(8):1854-60. Epub 2010 Feb 5. 2 Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. 2010 Aug;24(8):1842-8. Epub 2010 Feb 20. While clinical studies support the use of the da Vinci Surgical System as an effective tool for minimally invasive surgery, individual results may vary. Before performing any clinical procedure utilizing the System, physicians are responsible for receiving sufficient training and proctoring to ensure that they have the requisite training, skills and experience necessary to protect the health and safety of the patient. For technical information, including full cautions and warnings on using the System, please refer to the System User Manual. Read all instructions carefully. Failure to properly follow instructions, <strong>no</strong>tes, cautions, warnings, and danger messages associated with this equipment may lead to serious injury or complications for the patient. All persons depicted are models. © <strong>2011</strong> Intuitive Surgical. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S HD, InSite, TilePro, Single-Site and EndoWrist are trademarks or registered trademarks of Intuitive Surgical. All other product names are trademarks or registered trademarks of their respective holders. PN874471 Rev. A 04/11
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