JMIG+ergonomics+paper+accepted+version+with+tables+&+figures.pdf (1.37 MB)
Impact of Obesity on Surgeon Ergonomics in Robotic and Straight-Stick Laparoscopic Surgery
journal contribution
posted on 2019-07-18, 11:30 authored by E Moss, P Sarhanis, T Ind, M Smith, Q Davies, M ZeccaStudy Objective
Work-related musculoskeletal symptoms (WMSs) are reported to be increasing in surgeons performing minimally invasive procedures. Therefore, we investigated the use of inertial measurement units (IMUs) and electromyography (EMG) sensor recorders to record real-time information on the muscle movement/activity required to perform training exercises in simulated in normal and high body mass index (BMI) models.
Design
Prospective study.
Setting
University hospital.
Participants
Four consultant gynecologic oncology surgeons experienced in complex straight-stick (SS) laparoscopic and robotically assisted (RA) surgery.
Interventions
Three exercises (hoops onto pegs and wire chase) using SS and RA surgery on 2 abdominal models: normal BMI and high BMI.
Measurements and Main Results
We measured time to complete exercise and surgeon muscle movement/activity. The time to complete all exercises was significantly lower for RA surgery as compared with SS laparoscopy (p <.05 or better). The movement of the surgeons’ core was significantly greater in high BMI SS laparoscopy compared with normal BMI SS laparoscopy for exercises 1 and 2 (p <.001). Muscle usage, as determined by EMG peak, was significantly higher in normal BMI SS laparoscopy and even higher in high BMI SS laparoscopy but was generally flat for all normal and high BMI RA surgery exercises (p <.05 or better).
Conclusion
Detailed real-time information can be collected through IMUs/EMG sensors. Our results indicate that RA surgery requires less surgeon movements and muscle activity to complete tasks compared with SS laparoscopy, particularly in a high BMI model. The implications of these results are that RA surgery in high BMI patients may therefore have less physical impact on the surgeon compared with SS laparoscopy and may result in lower WMS rates.
Funding
Intuitive Surgical provided the robotic instruments and the abdominal model on which the exercises were performed.
History
Citation
Journal of Minimally Invasive Gynecology, Volume 27, Issue 5, July–August 2020, Pages 1063-1069Author affiliation
/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Cancer Research CentreVersion
- AM (Accepted Manuscript)