Zhe Liang1, William D Gerull2, Robert Wang3, Ahmed Zihni1, Shuddhadeb Ray1, Michael Awad1. 1. Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, MO, USA. 2. Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, MO, USA. wgerull@wustl.edu. 3. Urology, University of Michigan Medical School, Ann Arbor, MI, USA.
Abstract
BACKGROUND: Minimally invasive surgery may introduce new ergonomic challenges for surgeons. Increased patient body mass index (BMI) may further add to this ergonomic stress. OBJECTIVES: The objective of this study was to quantify the ergonomic impact of patient BMI on surgeons during laparoscopic surgery. SETTING: University Hospital, USA. METHODS: This prospective cohort study analyzed five minimally invasive surgeons during 24 laparoscopic procedures. Each subject's muscle stress was assessed by recording surface electromyography (EMG) data from eight upper body muscle groups during laparoscopic procedures. EMG data was normalized against the maximal voluntary contraction (MVC) of each muscle measured before the start of surgery to create a percentage of the MVC value (%MVC). Subject workload was assessed through the NASA Task Load Index (NTLX). Statistical analysis was used to determine significance between surgeons operating on patients with or without obesity for %MVC and NTLX scores. RESULTS: There was no significant difference (p > 0.05) in both the average muscle activation of all eight muscle groups and NTLX scores during laparoscopic surgery in surgeons operating on patients with BMI > = 30 compared with patients with a BMI < 30. CONCLUSIONS: We detected no differences in ergonomic stress or workload for surgeons operating on patients with or without obesity. For surgeons, the laparoscopic approach may offer an additional advantage over open surgery in patients with obesity. This advantage may be due to an "equalizing effect" of laparoscopy-that surgical ergonomics are less affected by the BMI of the patient when using laparoscopic tools.
BACKGROUND: Minimally invasive surgery may introduce new ergonomic challenges for surgeons. Increased patient body mass index (BMI) may further add to this ergonomic stress. OBJECTIVES: The objective of this study was to quantify the ergonomic impact of patient BMI on surgeons during laparoscopic surgery. SETTING: University Hospital, USA. METHODS: This prospective cohort study analyzed five minimally invasive surgeons during 24 laparoscopic procedures. Each subject's muscle stress was assessed by recording surface electromyography (EMG) data from eight upper body muscle groups during laparoscopic procedures. EMG data was normalized against the maximal voluntary contraction (MVC) of each muscle measured before the start of surgery to create a percentage of the MVC value (%MVC). Subject workload was assessed through the NASA Task Load Index (NTLX). Statistical analysis was used to determine significance between surgeons operating on patients with or without obesity for %MVC and NTLX scores. RESULTS: There was no significant difference (p > 0.05) in both the average muscle activation of all eight muscle groups and NTLX scores during laparoscopic surgery in surgeons operating on patients with BMI > = 30 compared with patients with a BMI < 30. CONCLUSIONS: We detected no differences in ergonomic stress or workload for surgeons operating on patients with or without obesity. For surgeons, the laparoscopic approach may offer an additional advantage over open surgery in patients with obesity. This advantage may be due to an "equalizing effect" of laparoscopy-that surgical ergonomics are less affected by the BMI of the patient when using laparoscopic tools.
Entities:
Keywords:
EMG; NASA TLX; Obesity; Surgical ergonomics
Authors: Gyusung Lee; Tommy Lee; David Dexter; Carlos Godinez; Nora Meenaghan; Robert Catania; Adrian Park Journal: Surg Endosc Date: 2008-09-25 Impact factor: 4.584
Authors: Ahmed Zihni; Tianjia Ge; Shuddhadeb Ray; Robert Wang; Zhe Liang; Jaime A Cavallo; Michael M Awad Journal: J Surg Res Date: 2016-06-16 Impact factor: 2.192
Authors: Ahmed M Zihni; Ikechukwu Ohu; Jaime A Cavallo; Jenny Ousley; Sohyung Cho; Michael M Awad Journal: Surg Endosc Date: 2014-03-12 Impact factor: 4.584
Authors: Ahmed M Zihni; Jaime A Cavallo; Shuddhadeb Ray; Ikechukwu Ohu; Sohyung Cho; Michael M Awad Journal: J Surg Res Date: 2016-04-01 Impact factor: 2.192
Authors: P R Schauer; S Ikramuddin; R H McLaughlin; T O Graham; A Slivka; K K Lee; W H Schraut; J D Luketich Journal: Am J Surg Date: 1998-12 Impact factor: 2.565