Esther L Moss1, Panos Sarhanis2, Thomas Ind3, Michael Smith4, Quentin Davies5, Massimiliano Zecca6. 1. Leicester Cancer Research Centre (Miss Moss), University of Leicester, Leicester, United Kingdom; Department of Gynaecological Oncology (Miss Moss and Mr. Davies), University Hospitals of Leicester, Leicester, United Kingdom. Electronic address: em321@le.ac.uk. 2. Department of Gynaecology (Mr. Sarhanis), Northwick Park Hospital, Harrow, United Kingdom. 3. Department of Gynaecological Oncology (Mr. Ind), The Royal Marsden Hospital, London, United Kingdom. 4. Deparatment of Gynaecological Oncology (Mr. Smith), The Christie Hospital, Manchester, United Kingdom. 5. Department of Gynaecological Oncology (Miss Moss and Mr. Davies), University Hospitals of Leicester, Leicester, United Kingdom. 6. Wolfson School of Mechanical, Electrical and Manufacturing Engineering (Professor Zecca); National Centre for Sport and Exercise Medicine NCSEM-EM (Professor Zecca), Loughborough, United Kingdom.
Abstract
STUDY 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.
STUDY 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.