What is the ergonomic position recommended for intracorporeal knot tying?

• A. Elbows flexed at 90 degrees and ports at least 10 cm apart
• B. Elbows fully extended with ports less than 5 cm apart
• C. Elbows at 120 degrees with ports at least 20 cm apart
• D. Arms resting with no specified port distance

Answer: (A)

For intracorporeal knot tying, maintaining a neutral, comfortable posture with adequate working space is essential to control and precision. The recommended setup is elbows flexed at about 90 degrees and ports spaced at least 10 cm apart. This elbow angle keeps the arms in a midline, joint-friendly position that reduces shoulder and neck strain while allowing stable, dexterous instrument control. Having the ports at least 10 cm apart provides proper triangulation, giving enough room to maneuver each instrument without external collisions or crowding, which is crucial for precise knot tying inside the abdomen.

Other configurations tend to compromise ergonomics: elbows fully extended create unnecessary tension and fatigue, especially during long procedures; ports that are too close (<5 cm) limit range of motion and increase instrument clashes; and simply resting the arms with no specified port distance fails to establish the necessary working geometry for effective intracorporeal knot tying.