Optimal position and posture of operating surgeon to reduce radiation due to intraoperative use of image intensifier in extremity surgeries

Abstract

Background: The purpose of this study was to find out the optimal position and posture of the operating surgeon relative to the differing axis and viewing angles of the image intensifier in order to minimize intra operative radiation. Materials and methods: A simulated observational study was made using an image intensifier, operating table, a water phantom in lieu of the patient and a dosimeter used to record the amount of radiation at various positions. Results: Standard AP view- along the axis of the image intensifier, 58% reduction in radiation was observed when surgeon was standing as compared to sitting. Correspondingly perpendicular to the axis of the image intensifier 46% reduction in radiation was noted. Inverted position-along the axis of the image intensifier, 29% reduction in radiation was observed when surgeon was standing as compared to sitting. Correspondingly perpendicular to the axis of the image intensifier 20.5% reduction in radiation was noted. Lateral view- when surgeon was closer to the intensifier, 28% reduction in radiation was observed in sitting compared to standing. Correspondingly closer to the x ray source 58% reduction in radiation was noted. Conclusions: Radiation exposure to the surgeon was less in standard AP position of imaging compared to lateral and inverted views. In standard AP position, standing along the axis of the C arm caused less radiation to the surgeon. In inverted position surgeon sitting along the axis of the image intensifier was optimal. The surgeon received less radiation when positioned closer to the intensifier and sitting during the lateral view.