A virtual instrument ergonomics workstation for measuring the mental workload of performing video-endoscopic surgery

The visual and physical interface imposed on the surgeon by video-endoscopic surgery (VES) increases the surgeon's mental workload. Ergonomic studies are needed to develop ways to reduce this workload. We used virtual instrumentation to devise a portable ergonomic workstation to compare the surgeon's mental workloads during simulated open surgery and VES. The system measures palmar tonic skin conductance level (SCL) and electrooculogram (EOG) and frontalis electrical activity to monitor mental stress and concentration levels. We used the system at a national surgery conference on volunteer subjects during a rest period and as they performed simulated surgery, consisting of typing knots using open and VES techniques. The subjects were asked to self-rate their levels of mental concentration and stress during these activities and reported that both progressively increased from rest to the open surgery task to the VES task. The subjects tied fewer knots during the VES than the open task, consistent with the increased demands of the VES task. The SCL progressively increased from rest to the open task to the VES task, correlating with the subjects' reported increase in mental stress level. Eye blinks and low frequency EOG activity decreased from rest to the open task, consistent with the subjects' reported increase in mental concentration level. From the open to the VES task, eye blinks and EOG activity increased, as expected given the greater demands of the VES task. High frequency frontalis activity merits further study as another indicator of the subjects' levels of mental concentration and stress.