neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2024-26-1-76-82neurosurgery-1498Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTВлияние положения хирурга и длительности выполнения операции на точность движений и уровень микрохирургического тремораThe effect of surgeon’s pose and duration of operation on movement accuracy and level of microsurgical hand tremorhttps://orcid.org/0000-0002-0588-4779БыкановА. Е.BykanovA. E.

Андрей Егорович Быканов 

125047 Москва, ул. 4-я Тверская-Ямская, 16

Andrey Egorovich Bykanov 

16 4th Tverskaya-Yamskaya St., Moscow 125047

abykanov7@gmail.comhttps://orcid.org/0000-0003-0374-7970ПицхелауриД. И.PitskhelauriD. I.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

КирюшинМ. А.KirushinM. A.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0003-2820-9124РаствороваО. А.RastvorovaO.  A.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-5621-6834ЗагидуллинТ. Р.ZagidullinT. R. 

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н. Н. Бурденко» Минздрава РоссииРоссияN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian Federation2024040420242617682Copyright © Быканов А.Е., Пицхелаури Д.И., Кирюшин М.А., Растворова О.А., Загидуллин Т.Р., 20242024Быканов А.Е., Пицхелаури Д.И., Кирюшин М.А., Растворова О.А., Загидуллин Т.Р.Bykanov A.E., Pitskhelauri D.I., Kirushin M.A., Rastvorova O.A., Zagidullin T.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1498Введение

Введение. Физиологический тремор – одна из значимых проблем при выполнении микрохирургической техники. Одно неосторожное движение может повлечь за собой повреждение соседних анатомических структур и, как следствие, ухудшение состояния пациента. Поэтому вопрос о снижении тремора остается актуальным по сей день.

Цель исследования – определить влияние позы микрохирурга, длительности выполнения операции на точность двигательного хирургического действия и уровень микрохирургического тремора.

Материалы и методы

Материалы и методы. Исследование проведено при участии 14 ординаторов‑нейрохирургов, соответствующих критериям включения. Для оценки и симуляции микрохирургического действия использовали валидированные и разработанные авторами исследования устройства для тестирования и операционный микроскоп Carl Zeiss. Результаты экспериментов сравнивали между собой с помощью однофакторного анализа. Различия признавали статистически значимыми при p <0,05.

Результаты

Результаты. Статистически значимо на пространственную точность двигательного хирургического действия и уровень микрохирургического тремора не влияли варианты положения микрохирурга стоя / сидя. Однако отмечалось статистически значимое изменение тремора как в положении стоя, так и в положении сидя по мере увеличения продолжительности микрохирургического действия.

Заключение

Заключение. Выбор положения сидя или стоя для выполнения микрохирургической операции не является фактором, существенно влияющим на пространственную точность движений и тремор микрохирурга. Длительность оперативного вмешательства влияет на уровень микрохирургического тремора.

Background

Background. Physiological hand tremor is one of significant problems in microsurgical technique. One careless movement can cause damage to the neighboring structures and consequently worsen a patient’s condition. Therefore, the problem of reducing hand tremor remains relevant.

Aim

Aim. To determine the effect of microsurgeon’s pose, duration of operation on the accuracy of surgical action and level of microsurgical hand tremor.

Materials and methods

Materials and methods. The study included 14 neurosurgery residents satisfying inclusion criteria. For evaluation and simulation of microsurgical action, validated and developed by the study authors devices for testing and surgical  microscope Carl Zeiss were used. The experimental results were compared using univariate analysis. The differences were considered statistically significant at p <0.05.

Results

Results. Surgeon’s pose standing / sitting did not affect spatial accuracy of surgical action and the level of microsurgical hand tremor. However, statistically significant changes in hand tremor were observed both in standing and sitting positions with increased time of microsurgical action.

Conclusion

Conclusion. The choice between sitting or standing pose for microsurgical operation is not a factor significantly affecting microsurgeon’s spatial accuracy of movement and hand tremor. Duration of surgical intervention affects the level of microsurgical hand tremor.

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The authors declare that there are no conflicts of interest present.