The surgical lighting problem: ‘Manipulation problems with the surgical lighting system during surgical procedures’

The surgical lighting problem: ‘Manipulation problems with the surgical lighting system during surgical procedures’

Mooijweer, R.

Knulst, A.J. (mentor)

Mechanical, Maritime and Materials Engineering

Department Biomechanical Engineering (BMechE)

Biomedical Engineering

2011-02-18

Ergonomic problems of surgical lighting systems have been indicated by surgeons; however, the underlying causes are not clear. The aim of this dissertation is to assess the problems in detail, and subsequently clarify the underlying causes. In the first stage of the research, the observation method was used to quantify the luminaire use during 46 hours of open routine surgical procedures in the field of general surgery. The location of the observation study was the Reinier de Graaf Gasthuis hospital in Delft, which employs the Berchtold Chromophare C series as the surgical lighting system. The results showed that every 7.5 minute a luminaire action takes place, intended to reposition the luminaire. Of these LAs, 74% was performed by surgeons and residents. For 64% of these LAs the surgical tasks of OR-staff were interrupted. Observed difficulties were collision of the luminaire against any object, or that the luminaire was out of reach for the surgeon in a sitting posture. The primary difficulty appeared in the kinetic relation during the SLS and user interaction, as manoeuvrability of the luminaire was cumbersome and in some situations the system was immovable. These problems primarily occur during the repositioning of the luminaire 2 dimensional plane of the pendant arms. In the second research stage a valid simulation model of the surgical lighting system was constructed in MSC Adams software to allow virtual experiments to analyse the system mechanics. The model showed that the required force during luminaire usage depends on the location of the luminaire its work field and are on average higher than ergonomically acceptable. Primary cause of this difficulty with the current systems is the two pendant arms construction as the highest forces were found when the luminaire was directly below the ceiling suspension or in the peripheral region of the work field. In those regions the pendant arms are either in parallel or serial alignment. The force spectrum for luminaire use showed a diffuse image, ranging from 14 Newton till unlimited quantities when the system is unmovable. The average required force is 136 Newton in the region where the observed luminaire use was primarily undertaken. In addition, the software engineering model which was constructed in this study is applicable as a test procedure to analyse surgical lighting systems. As a result, this dissertation stated novel insights into the OR lighting problem during open routine surgical procedures in the field of general surgery. And it presented a valid simulation model of a surgical lighting system Berchtold Chromophare C series. The protocol for the model construction can be user to analyse surgical lighting system of different brands using engineering software simulation. Furthermore, this dissertation presented a direction for future research and an improved user system interaction of the luminaire during surgical procedures.

ergonomics
equipment
operating room technology
surgical lighting
usability

http://resolver.tudelft.nl/uuid:fcc19d6c-ad6d-46ea-b1bd-41166416aa6f

2012-01-01

Student theses

master thesis

(c) 2011 Mooijweer, R.