International Surgery Journal | July 2021 | Vol 8 | Issue 7 Page 2145 International Surgery Journal Joshi G et al. Int Surg J. 2021 Jul;8(7):2145-2149 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Short Communication Study of ergonomics in terms of angle of manipulation and angle of azimuth in laparoscopic splenectomy Gaurav Joshi, Khaja Abdul Moin Baig, Aparajita Chaturvedi, Jnaneshwari Jayaram, Yashvant S. Rathore*, Sunil Chumber INTRODUCTION As the understanding and practice of laparoscopy grew among surgeons, the number of procedures as well as their complexities grew. LS required a relatively high muscular load, putting surgeons at risk for fatigue and injury. 1 With increased number of complex procedures, it becomes very important for surgeons to learn the ergonomics of laparoscopy which involves the art of laparoscopic instrument manipulation safely and effectively, so that they can perform laparoscopic procedures with minimal body fatigue and discomfort. With increased number of laparoscopic procedures, the surgeons have started experiencing problems of spondylosis, carpel tunnel syndrome, chronic back and neck pain. These health issues among laparoscopic surgeons are avoidable upto certain extent by knowing the ergonomics of the procedure to be performed and practice of the same. As per baseball diamond concept of port position, experimentally it is well known that putting camera port in the line of target organ and working port equidistant from camera port such that they form a 30 degree angle each, gives optimum ergonomic advantage. 2 However ABSTRACT As per baseball diamond concept of port position, experimentally it is well known that putting camera port in the line of target organ and working port equidistant from camera port such that they form a 30º angle each gives optimum ergonomic advantage. However while performing laparoscopic surgeries in humans it is seldom possible to achieve such port position. No such study has ever been attempted to find out value of angle of manipulation and angle of azimuth while performing laparoscopic procedure. Purpose of our study was to measure such angles in our patients during laparoscopic splenectomy (LS) and to verify the concept of baseball position of ports in the procedure. This was a prospective observational study where angle of manipulation between right and left working port of surgeon and angle of azimuth of both working instruments with the camera were measured intraoperatively. In our series of 12 patients who underwent LS in lateral position, we found angle of manipulation ranging from 41-85°. The azimuth angle between first working port (epigastric) and camera port was in the range of 22-45° and the azimuth angle between camera port and second working port was in the range of 19-40°. This was a first study that gave valuable insight into the application of theoretical concept of triangulation in port placement in LS. This study may guide the surgeons to measure and to modify the port position to gain advantage of better ergonomics and better long term health Keywords: Laparoscopic splenectomy, Angle of manipulation, Angle of azimuth Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India Received: 23 April 2021 Revised: 23 May 2021 Accepted: 28 May 2021 *Correspondence: Dr. Yashvant S. Rathore, E-mail: dryashvant.r@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-2902.isj20212723