Vị trí đặc biệt có thể dẫn đến vấn đề đặc biệt, ví dụ như, hoạt động từ phía các kết quả bệnh nhân mệt mỏi cơ bắp ở vai Ngồi thay vì đứng yên tĩnh và cung cấp một tư thế ổn định hơn cho các công cụ kiểm soát trong Không có nghiên cứu so sánh giữa đứng và ngồi phẫu thuật | Ergonomics 45 surgery standing endoscopic surgeons operate in a more upright position and with much less body movement and weight Moreover as most energy supplying systems are operated by foot the standing endoscopic surgeon basically stands on one leg for most of the procedure. Special positions may result in special problems . operating from the side of the patient results in muscle fatigue in the shoulder Sitting instead of standing is more restful and provides a more stable posture for controlling instruments during No comparative studies between standing and sitting surgery are available yet. As far as stability of the instruments is concerned there is a big difference with microsurgery as the ports in endoscopic surgery stabilise the instrument. Nevertheless operating in a sitting position will cause less static fatigue. Moreover a sitting position will allow for a better control of the energy supplying systems. In fact in a sitting position both feet are available for operational use. The postural problems are compounded by the often long duration of endoscopic procedures. Mental and Physical Workload The surgeon has to reconstruct a 3D picture from a 2D image and to perform the task under several mechanical and visual 4 Moreover he often stands for a long time in a more or less upright position and with less mobility of the head and neck and less anteroposterior weight shifting than during open surgery. The physical mental and visual demands of endoscopic manipulations may be responsible for surgical fatigue syndrome encountered in endoscopic surgery. After a variable but finite time the surgical fatigue syndrome sets in manifested by mental exhaustion increased irritability impaired surgical judgement and reduced level of psychomotor Operating Room Environment To put facts found out by research in the field of ergonomics into practice operating rooms have to be adjusted. This is a problem
