TY - JOUR
T1 - Ergonomics Analysis for Subjective and Objective Fatigue Between Laparoscopic and Robotic Surgical Skills Practice Among Surgeons
AU - Rodrigues Armijo, Priscila
AU - Huang, Chun Kai
AU - Carlson, Tyson
AU - Oleynikov, Dmitry
AU - Siu, Ka Chun
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the SAGES Robotic Surgery Research Grant 2016 and Center for Advanced Surgical Technology at the University of Nebraska Medical Center.
Funding Information:
https://orcid.org/0000-0003-2877-1766 Rodrigues Armijo Priscila MD 1 https://orcid.org/0000-0002-4220-4410 Huang Chun-Kai PhD 1 2 Carlson Tyson BS 1 Oleynikov Dmitry MD 1 Siu Ka-Chun PhD 1 1 University of Nebraska Medical Center, Omaha, NE, USA 2 University of Kansas Medical Center, Kansas City, KS, USA Priscila Rodrigues Armijo, Department of Surgery, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE 68198-6246, USA. Email: [email protected] 11 2019 1553350619887861 © The Author(s) 2019 2019 SAGE Publications Introduction . Our aim was to determine how self-reported and objectively measured fatigue of upper limb differ between laparoscopic and robotic surgical training environments. Methods . Surgeons at the 2016 SAGES Conference Learning Center and at our institution were enrolled. Two standardized surgical tasks (peg transfer [PT] and needle passing [NP]) were performed twice in each surgical skills practical environments: (1) laparoscopic training-box environment (Fundamentals of Laparoscopic Surgery [FLS]) and (2) Mimic dV-trainer (MIMIC). Muscle activation of upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis, and extensor digitorum were recorded using surface electromyography (EMG; Trigno, Delsys, Inc, Natick, MA). Subjective fatigue was self-reported using Piper Fatigue Scale-12. Analysis was done using SPSS v25.0, α = .05. Results . Demographics were similar between FLS (N = 14) and MIMIC (N = 12). For PT, MIMIC had a significant increase in EMG RMS of UT ( P < .001) and AD ( P < .001). Conversely, FLS led to significant decreased muscle fatigue in UT ( P = .015). For NP, MIMIC had a significant increase in EMG RMS for UT ( P = .034) and AD ( P = .031), but FLS induced more muscle fatigue for AD ( P = .004). There was significant decrease in self-reported fatigue after performing FLS tasks ( P = .030) but not after MIMIC ( P = .663). Conclusion . Our results showed that practice with MIMIC resulted in greater activation of shoulder muscles, while FLS caused more significant muscle fatigue in the same muscles. This could be due to ergonomic disadvantages and nonoptimal ergonomic settings. Further studies are needed to understand the optimal ergonomics and its impact on fatigue and muscle activation during use of both the FLS and MIMIC training systems. ergonomics human factors study simulation surgical education Society of American Gastrointestinal and Endoscopic Surgeons https://doi.org/10.13039/100008743 SAGES Research Grant edited-state corrected-proof Authors’ Note Information in this article was presented as a Poster Presentation at the SAGES 2018 Annual Meeting, April 11 to 14, 2018, Seattle, WA. Author Contributions Study concept and design: Priscila Rodrigues Armijo, Dmitry Oleynikov, Ka-Chun Siu Acquisition of data: Priscila Rodrigues Armijo, Chun-Kai Huang, Dmitry Oleynikov, Ka-Chun Siu Analysis and interpretation: Priscila Rodrigues Armijo, Chun-Kai Huang, Tyson Carlson, Dmitry Oleynikov, Ka-Chun Siu Study supervision: Ka-Chun Siu Declaration of Conflicting Interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Dmitry Oleynikov is a stock holder at Virtual Incision Corporation. The other authors have no conflicts of interest to disclose. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the SAGES Robotic Surgery Research Grant 2016 and Center for Advanced Surgical Technology at the University of Nebraska Medical Center. ORCID iDs Priscila Rodrigues Armijo https://orcid.org/0000-0003-2877-1766 Chun-Kai Huang https://orcid.org/0000-0002-4220-4410
Publisher Copyright:
© The Author(s) 2019.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Introduction. Our aim was to determine how self-reported and objectively measured fatigue of upper limb differ between laparoscopic and robotic surgical training environments. Methods. Surgeons at the 2016 SAGES Conference Learning Center and at our institution were enrolled. Two standardized surgical tasks (peg transfer [PT] and needle passing [NP]) were performed twice in each surgical skills practical environments: (1) laparoscopic training-box environment (Fundamentals of Laparoscopic Surgery [FLS]) and (2) Mimic dV-trainer (MIMIC). Muscle activation of upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis, and extensor digitorum were recorded using surface electromyography (EMG; Trigno, Delsys, Inc, Natick, MA). Subjective fatigue was self-reported using Piper Fatigue Scale-12. Analysis was done using SPSS v25.0, α =.05. Results. Demographics were similar between FLS (N = 14) and MIMIC (N = 12). For PT, MIMIC had a significant increase in EMGRMS of UT (P <.001) and AD (P <.001). Conversely, FLS led to significant decreased muscle fatigue in UT (P =.015). For NP, MIMIC had a significant increase in EMGRMS for UT (P =.034) and AD (P =.031), but FLS induced more muscle fatigue for AD (P =.004). There was significant decrease in self-reported fatigue after performing FLS tasks (P =.030) but not after MIMIC (P =.663). Conclusion. Our results showed that practice with MIMIC resulted in greater activation of shoulder muscles, while FLS caused more significant muscle fatigue in the same muscles. This could be due to ergonomic disadvantages and nonoptimal ergonomic settings. Further studies are needed to understand the optimal ergonomics and its impact on fatigue and muscle activation during use of both the FLS and MIMIC training systems.
AB - Introduction. Our aim was to determine how self-reported and objectively measured fatigue of upper limb differ between laparoscopic and robotic surgical training environments. Methods. Surgeons at the 2016 SAGES Conference Learning Center and at our institution were enrolled. Two standardized surgical tasks (peg transfer [PT] and needle passing [NP]) were performed twice in each surgical skills practical environments: (1) laparoscopic training-box environment (Fundamentals of Laparoscopic Surgery [FLS]) and (2) Mimic dV-trainer (MIMIC). Muscle activation of upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis, and extensor digitorum were recorded using surface electromyography (EMG; Trigno, Delsys, Inc, Natick, MA). Subjective fatigue was self-reported using Piper Fatigue Scale-12. Analysis was done using SPSS v25.0, α =.05. Results. Demographics were similar between FLS (N = 14) and MIMIC (N = 12). For PT, MIMIC had a significant increase in EMGRMS of UT (P <.001) and AD (P <.001). Conversely, FLS led to significant decreased muscle fatigue in UT (P =.015). For NP, MIMIC had a significant increase in EMGRMS for UT (P =.034) and AD (P =.031), but FLS induced more muscle fatigue for AD (P =.004). There was significant decrease in self-reported fatigue after performing FLS tasks (P =.030) but not after MIMIC (P =.663). Conclusion. Our results showed that practice with MIMIC resulted in greater activation of shoulder muscles, while FLS caused more significant muscle fatigue in the same muscles. This could be due to ergonomic disadvantages and nonoptimal ergonomic settings. Further studies are needed to understand the optimal ergonomics and its impact on fatigue and muscle activation during use of both the FLS and MIMIC training systems.
KW - ergonomics
KW - human factors study
KW - simulation
KW - surgical education
UR - http://www.scopus.com/inward/record.url?scp=85076003369&partnerID=8YFLogxK
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U2 - 10.1177/1553350619887861
DO - 10.1177/1553350619887861
M3 - Article
C2 - 31771411
AN - SCOPUS:85076003369
SN - 1553-3506
VL - 27
SP - 81
EP - 87
JO - Surgical Innovation
JF - Surgical Innovation
IS - 1
ER -