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Surgical Endoscopy

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01-02-2022

Ergonomic effects of medical augmented reality glasses in video-assisted surgery

Authors: Ae Kyeong Lim, Junsun Ryu, Hong Man Yoon, Hee Chul Yang, Seok-ki Kim

Published in: Surgical Endoscopy | Issue 2/2022

Abstract

Background

The aim of this study was to objectively compare medical augmented reality glasses (ARG) and conventional monitors in video-assisted surgery and to systematically analyze its ergonomic benefits.

Methods

Three surgeons (thoracic, laparoscopic, and thyroid surgeons) participated in the study. Six thoracoscopic metastasectomies, six subtotal laparoscopic gastrectomies, and six thyroidectomies were performed with and without ARG. The subjective experience was evaluated using a questionnaire-based NASA-Task Load Index (NASA-TLX). Postures during surgeries were recorded. The risk of musculoskeletal disorders associated with video-assisted surgery was assessed using rapid entire body assessment (REBA). Surface electromyography (EMG) was recorded. Muscle fatigue was objectively measured.

Results

NASA-TLX scores of three surgeons were lower when ARG was used compared to those with conventional monitor (66.4 versus 82.7). Less workload during surgery was reported with ARG. The laparoscopic surgeon exhibited a substantial decrease in mental and physical demand [− 21.1 and 12.5%)] and the thyroid surgeon did (− 40.0 and − 66.7%).Total REBA scores decreased with ARG (8 to 3.6). The risk of musculoskeletal disorders was improved in regions of the neck and shoulders. Root mean square (RMS) of the EMG signal decreased from 0.347 ± 0.150 to 0.286 ± 0.130 (p = 0.010) with usage of ARG; a decrease was observed in all surgeons. The greatest RMS decrease was observed in trapezius and sternocleidomastoid muscles. The decrease in brachioradialis muscle was small.

Conclusion

ARG assisted with correction of bad posture in surgeons during video-assisted surgery and reduced muscular fatigue of the upper body. This study highlights the superior ergonomic efficiency of ARG in video-assisted surgery.

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Wolf JS Jr, Marcovich R, Gill IS, Sung GT, Kavoussi LR, Clayman RV, McDougall EM, Shalhav A, Dunn MD, Afane JS (2000) Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery. Urology 55(6):831–836CrossRef

Berguer R, Forkey D, Smith W (2001) The effect of laparoscopic instrument working angle on surgeons’ upper extremity workload. Surg Endosc 15(9):1027–1029CrossRef

Lasser MS, Ghavamian R (2012) Surgical complications of laparoscopic urological surgery. Arab J Urol 10(1):81–88CrossRef

Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, Rieger NA, Smith J, Solomon MJ, Stevenson AR (2010) Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection. Br J Surg 97(1):86–91CrossRef

Satava R (1993) 3-D vision technology applied to advanced minimally invasive surgery systems. Surg Endosc 7(5):429–431CrossRef

Patankar SB, Padasalagi GR (2017) Three-dimensional versus two-dimensional laparoscopy in urology: a randomized study. Indian J Urol 33(3):226CrossRef

http://www.keithv.com/software/nasatlx/nasatlx.html

Hart SG (ed) (2006) NASA-task load index (NASA-TLX); 20 years later. In: Proceedings of the human factors and ergonomics society annual meeting. Sage Publications

Tirgar A, Khallaghi S, Taghipour M (2013) A study on musculoskeletal disorders and personal and occupational risk factors among surgeons. Iranian J Health Sci 1(1):50–57CrossRef

10.

Moritani T, Muro M, Nagata A (1986) Intramuscular and surface electromyogram changes during muscle fatigue. J Appl Physiol 60(4):1179–1185CrossRef

11.

Kent-Braun JA (1999) Central and peripheral contributions to muscle fatigue in humans during sustained maximal effort. Eur J Appl Physiol 80(1):57–63CrossRef

12.

Soderberg GL (1992) Selected topics in surface electromyography for use in the occupational setting: expert perspectives. US Department of Health and Human Services, Public Health Service, Centers

13.

Vettoretto N, Foglia E, Ferrario L, Arezzo A, Cirocchi R, Cocorullo G, Currò G, Marchi D, Portale G, Gerardi C (2018) Why laparoscopists may opt for three-dimensional view: a summary of the full HTA report on 3D versus 2D laparoscopy by SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie). Surg Endosc 32(6):2986–2993CrossRef

14.

Miller K, Benden M, Pickens A, Shipp E, Zheng Q (2012) Ergonomics principles associated with laparoscopic surgeon injury/illness. Hum Factors 54(6):1087–1092CrossRef

15.

Choi SD (2012) A review of the ergonomic issues in the laparoscopic operating room. J Healthc Eng 3(4):587–603CrossRef

16.

Szeto G, Ho P, Ting A, Poon J, Tsang R, Cheng S (2010) A study of surgeons’ postural muscle activity during open, laparoscopic, and endovascular surgery. Surg Endosc 24(7):1712–1721CrossRef

17.

Berguer R, Forkey D, Smith W (1999) Ergonomic problems associated with laparoscopic surgery. Surg Endosc 13(5):466–468CrossRef

18.

Liu D, Jenkins SA, Sanderson PM (eds) (2009) Clinical implementation of a head-mounted display of patient vital signs. In: International Symposium on Wearable Computers. IEEE

19.

Chang JYC, Tsui LY, Yeung KSK, Yip SWY, Leung GKK (2016) Surgical vision: google Glass and surgery. Surg Innov 23(4):422–426CrossRef

20.

Eckardt C, Paulo EB (2016) Heads-up surgery for vitreoretinal procedures: an experimental and clinical study. Retina 36(1):137–147CrossRef

21.

Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, Szold A (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg 193(4):519–522CrossRef

22.

Chang J, Jung K, Moon SK, Kim W, Freivalds A, Simpson TW, Baik SP (eds) (2012) Determination of optimal location of circuit board and battery on 3D glasses by considering nose load and subjective discomfort. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting; SAGE Publications

23.

Morisawa T, Kida H, Kusumi F, Okinaga S, Ohana M (2015) Endoscopic submucosal dissection using head-mounted display. Gastroenterology 149(2):290–291CrossRef

24.

Hart SG, Staveland LE (1988) Development of NASA-TLX (Task Load Index): results of empirical and theoretical research. In: Advances in psychology. Elsevier, Amsterdam, vol 52, pp 139–183

25.

Jung HS, Jung H-S (2001) Establishment of overall workload assessment technique for various tasks and workplaces. Int J Ind Ergon 28(6):341–353CrossRef

Title: Ergonomic effects of medical augmented reality glasses in video-assisted surgery
Authors: Ae Kyeong Lim
Junsun Ryu
Hong Man Yoon
Hee Chul Yang
Seok-ki Kim
Publication date: 01-02-2022
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 2/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-021-08363-8

At a glance: The STEP trials

Springer Medicine

Ergonomic effects of medical augmented reality glasses in video-assisted surgery

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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