**3. Anthropometry**

The adaptation of the laparoscopic surgery's environment and of the equipment based on ergonomic criteria must take into account that the seated position cannot be adopted because it conditions the angle of incidence of the instruments [20] and the morphological characteristics of the users. Anthropometry provides information regarding the dimensions of the human body in a certain (static) position, as well as the ranges of movement of the body parts, reach, trajectories, surfaces, and volumes of movement (functional). Although different types of anthropometers have been developed over the last decades, BioẼrgon Research Group has developed a procedure based on three-dimensional photogrammetry of BiomSoft 2.0 software [21] (**Figure 7**) to obtain anthropometric data assisted by a Vitus Smart XXL® system (human solutions) of full-body scanning, capable to provide anthropometric data in industrial quantities with ±1 mm level of accuracy, in accordance with the international standard DIN EN ISO 20685 (**Figure 8**).

**15**

**Figure 8.**

*A 3D scanner for anthropometry.*

*Advanced Ergonomics in Laparoscopic Surgery DOI: http://dx.doi.org/10.5772/intechopen.84233*

The obtained information is relevant to formulate criteria and recommendations

for ergonomic intervention in the laparoscopic surgery scenario, such as working in a standing position with sufficient space for the hands and with properly dimensioned tools especially in the handles, to avoid tensions in the arm and wrist and to allow handling of the tools to be comfortable for the hands. The ISO 6385 [22] standard recommends adapting the height of the work surface to the user's dimensions for tasks, having enough space for body movements, having tables and controls within reach, and providing tools with handles adapted to the user's hand. The required levels of strength should be within the desirable limits, and the movements of the body should be natural and soft. Finally, the movements of the trunk

As during the performance of laparoscopic surgery a standing posture is adopted, it is important to regulate and adapt the height of the operating table, the height of the monitor, and its orientation and the space for the feet to be able to operate near the surface of the operating table to the morphological and functional characteristics of the surgeon. The placement of the elements in the surgeon's environment should facilitate the adoption of a comfortable posture, especially in the early stages of learning laparoscopic techniques, avoiding excessive inclinations and/or torsions of the trunk and head, as well as abduction of the shoulders. In this context, characterization studies of the adopted position and its consequences during simulations of laparoscopic operations have been carried out. In the first phase of performed studies, the application of the OWAS protocol [23] was used as a standardized process to characterize the level of risk for tasks and for postures that were forced, nonrepetitive, and without defined work cycles, taking into account the posture of the trunk, arms, and legs as well as depending on the level of the load or force exerted by the surgeon. This process allowed to assess the level of risk for surgeons caused by the maintenance of the analyzed postures for a prolonged period of

should not introduce excessive inclinations and/or torsions.

**4. Characterization and motor control of posture**

**4.1 Ovako working posture analysis system**

**Figure 7.** *BiomSoft 2.0 flow chart.*

*Advanced Ergonomics in Laparoscopic Surgery DOI: http://dx.doi.org/10.5772/intechopen.84233*

*Recent Advances in Laparoscopic Surgery*

dissector (4%).

**Figure 6.**

**3. Anthropometry**

they reported having experienced difficulties with handling the needle holder (22%), handling the suction-irrigation equipment (15%), with the view of the monitor (8%), with scissors (6%), with diathermy equipment (6%), and with the

The adaptation of the laparoscopic surgery's environment and of the equipment based on ergonomic criteria must take into account that the seated position cannot be adopted because it conditions the angle of incidence of the instruments [20] and the morphological characteristics of the users. Anthropometry provides information regarding the dimensions of the human body in a certain (static) position, as well as the ranges of movement of the body parts, reach, trajectories, surfaces, and volumes of movement (functional). Although different types of anthropometers have been developed over the last decades, BioẼrgon Research Group has developed a procedure based on three-dimensional photogrammetry of BiomSoft 2.0 software [21] (**Figure 7**) to obtain anthropometric data assisted by a Vitus Smart XXL® system (human solutions) of full-body scanning, capable to provide anthropometric data in industrial quantities with ±1 mm level of accuracy, in accordance with the

international standard DIN EN ISO 20685 (**Figure 8**).

*Frequency of appearance and pain intensity in the wrist-hand area.*

**14**

**Figure 7.**

*BiomSoft 2.0 flow chart.*

**Figure 8.** *A 3D scanner for anthropometry.*

The obtained information is relevant to formulate criteria and recommendations for ergonomic intervention in the laparoscopic surgery scenario, such as working in a standing position with sufficient space for the hands and with properly dimensioned tools especially in the handles, to avoid tensions in the arm and wrist and to allow handling of the tools to be comfortable for the hands. The ISO 6385 [22] standard recommends adapting the height of the work surface to the user's dimensions for tasks, having enough space for body movements, having tables and controls within reach, and providing tools with handles adapted to the user's hand. The required levels of strength should be within the desirable limits, and the movements of the body should be natural and soft. Finally, the movements of the trunk should not introduce excessive inclinations and/or torsions.
