SAN FRANCISCO, CA USA
It has long been recognized that laparoscopy presents challenging ergonomic issues for the surgeon. Previous investigators have found that neck, shoulder and back pain in the surgeon can all be associated and related directly to laparoscopic surgery. Researchers from Cincinnati, Ohio utilized the Alexander Technique (AT) as a process of psychophysical re-education of one’s body in order to improve postural balance and coordination and to evaluate the efficacy of this in improving posture during the performance of laparoscopic surgery.
They performed a prospective study on 8 subjects who served as their own controls, and underwent PreAT-Test of basic laparoscopic skill assessment, PreAT-Test of postural co-ordination, the planned AT education session and then PostAT basic laparoscopic skill assessment and postural co-ordination. All of the subjects reported a subjective improvement in their overall posture following the AT training session. There was a statistically significant difference in the PostAT Posture scores for the neck, spine, shoulder, hands and fingers in the subjects. The subjects also demonstrated improved ergonomics and improved ability to complete the skill sets with the PostAT load time test, suturing and cutting demonstrating statistically significant differences.
This AT training program resulted in significant improvement in posture, trunk endurance and surgical ergonomics and was accompanied by reduction and perceived discomfort when performing basic laparoscopic skills. This is certainly interesting information and warrants further investigation in other aspects of surgery. Perhaps the Alexander Technique of psychophysical re-education of the body will become part of surgical training.
Presented by Pramod Reddy, Trisha Reddy, Paul Noh, and Krishnanath Gaitonde the American Urological Association (AUA) Annual Meeting – May 29 – June 3, 2010 – Moscone Center, San Francisco, CA USA
Reported for UroToday by Jason Lee, MD, FRCSC, Department of Urology, University of California, Irvine