A Simulation Study of the Factors Influencing the Risk of Intraoperative Slipping

Abstract

Background

To identify the impact of weight, table surface, and table type on slipping in a simulation of minimally invasive gynecologic surgery.

Methods

A mannequin was placed into increasing Trendelenburg until a slip was observed; the table angle at the time of the event was measured (slip angle). The influence of mannequin position (supine vs. lithotomy), weight, table surface, and model was evaluated. A linear regression model was used to analyze the data.

Results

Mannequin weight, bed surface, and bed type all significantly impacted the slip angles. In general, higher mannequin weights tolerated significantly more Trendelenburg before slipping in the supine position but less in lithotomy compared to lower weights. In lithotomy, the disposable sheet and gelpad performed worse than the bean bag, egg crate foam, and bedsheet. There was no difference in slipping because of bed surface in the supine model. The Skytron operating table performed significantly better than the Steris operating table when tested with the bedsheet.

Conclusion

Operative position, patient weight, and bed surface together influence the slipping propensity. In lithotomy, heavier patients were more prone to slipping while the inverse was true in supine. The egg crate foam, bean bag, and bedsheet were the best antislip surfaces. Operating room table choice can mitigate slippage.