Surgery
the feel can only be appreciated with lightness of touch and the pulps of the fingers. The human ability to oppose the pulps of the fingers maximises this skill. “We all come in different shapes and sizes
– there are small hands and big hands, thin fingers and large fingers, as well as short and long fingers, notwithstanding some people use the left hand. “To date, instruments have been produced
for a surgical stereotype and the ergonomics have been largely ignored. This is surprising considering that musicians and athletes have recognised this for a long time.” The RCS England Bulletin highlighted a study of more than 600 surgeons in the
by Tran et al 9
US, in which just over half reported an injury related to operating. The Bulletin stated: “The neck, lower back and shoulders were the areas that caused the most problems, with the prevalence significantly higher among women. These musculoskeletal problems were having a serious impact on those involved: more than a quarter (26%) had had to have surgery to repair injuries caused by operating, and a similar proportion (24%) said their injuries affected the quality and duration of operations they could carry out. “In addition, a systematic review from 201810 found that surgeons and interventionalists had a prevalence of work-related musculoskeletal disorders at a similar level to that of labourers.”
New generation of surgical instrument design In terms of instrumentation, the solution rests with manufacturers and one company that is working with surgeons to tackle these issues is B. Braun. The company is rethinking and reinventing surgical instrumentation, working closely with current and next-generation surgeons to create instruments that better fit the workforce, delivering improved ergonomics
and easier reprocessing. Its Aesculap
SQ.line range has focused on meeting the needs of orthopaedic surgery with a suite of basic instruments that offer several ergonomic advantages, including mallets which provide 70% more grip in comparison to previous products, resulting in much less force to achieve a safe and comfortable grip during use. Indeed, 25% less force is needed to cut through wires compared to previous products, which translates to less fatigue for the operator. The range was extensively tested with male and female users with small, medium and large glove sizes. There was also a cadaver workshop where orthopaedic surgeons simulated a range of scenarios in hip surgery using 25 different types of
SQ.line instruments. The results confirmed that the reinvented handle design – with a new shape, contours and textural features – allows ergonomic working in physically demanding theatres for surgeons of different hand sizes. The design eliminates hard edges and leads to a balanced distribution of surface pressure and therefore fewer pressure points and joint stress during use. Surgeon feedback from eight countries around the world has also produced very
We all come in different shapes and sizes – there are small hands and big hands, thin fingers and large fingers as well as short and long fingers, notwithstanding some people use the left hand. To date, instruments have been produced for a surgical stereotype and the ergonomics have been largely ignored. This is surprising considering that musicians and athletes have recognised this for a long time.” David J. O’Regan, visiting professor, Imperial College.
positive feedback around the user-friendly weight and balance delivering smoother instrument handling.11 interviewed by B. Braun12
87% of surgeons believe the Aesculap
SQ.line design should help reduce the risk of surgical site infections by reducing the complexity for Central Sterile Services Departments. The design of the new instruments makes them easier to clean, saving time and helping reduce the risk of protein residues. Research carried out by B. Braun13
on double action
instruments found that manual pre-cleaning steps can be eliminated, with only machine cleaning and disinfection now required. This resulted in time savings of up to 12 minutes in handling time when compared to traditional designs. Further research additionally showed that the limit of protein residues was reached at an earlier stage during cleaning and disinfection, thereby reducing potential rework.14 Louise Skidmore, marketing manager at
B. Braun UK, said: “We developed the
SQ.line range of surgical instruments after recognising a number of issues that both clinicians and CSSD staff face every day, such as physical pain due to poor ergonomics and complex reprocessing of instrumentation. “In depth research at the development phase
gave us great insight into the functionality and ergonomic design requirements. Crucially this research included female surgeons who helped determine the need for improvements in relation to size, shape and weight of modern surgical instruments. “With this clear understanding, we were able
to create inclusive solutions to help clinicians work more ergonomically, helping to reduce pressure points, joint stress, and fatigue. “The orthopaedic range is the first of our
surgical instrument ‘reinventions’ with other specialties to follow... By working closely with hospitals, we harness new technology to increase efficiency, with a keen focus on health
March 2023 I
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