OPTIMAL MANIPULATION ANGLE FOR BEST LAPAROSCOPIC TASK PERFORMANCE

Optimal ‘manipulation angle ’ is required for best laparoscopic task performance. The port position governs the manipulation angle, elevation angle and the azimuth angle. Correct port placement ensures optimal manipulation angle required for maximal task efficiency. Objective: To investigate the effect of manipulation angle on a specific laparoscopic task and determine the optimal manipulation angle for best task performance. Design: The standardized task was to pick up 5 polo mint pieces and stack them over a tooth pick within an endotrainer box. Manipulation angles of 30 degrees, 60 degrees, 90 degrees and 120 degrees with a fixed elevation angle of 60 degrees were investigated with an endotrainer in the surgical skills lab. The table height was fixed and the azimuth angles were equal. This exercise was executed in a random sequence by 10 surgeons. The end-point was the execution time. Setting: Surgical skills lab in Laparoscopy Hospital, New Delhi Participants: Ten surgeons with previous experience in laparoscopy Main outcome measures: The execution time (in seconds) Results: A 60 degrees manipulation angle had the shortest execution time. Conclusion: The shortest execution time for the bimanual task was obtained with a manipulation angle of 60 degrees