A feasibility study determining surgical ergonomics in a live surgical setting

Area of Science:

• Minimally Invasive Surgery
• Surgical Ergonomics
• Biomechanics

Background:

• Laparoscopic surgery requires complex surgeon movements.
• Understanding these movements is crucial for preventing surgeon strain and injury.
• Current ergonomic assessments in live laparoscopic procedures are limited.

Purpose of the Study:

• To identify and quantify the biomechanical movements of surgeons during laparoscopic gynecologic procedures.
• To determine the feasibility of assessing and measuring these movements temporally and biomechanically.

Main Methods:

• Prospective descriptive kinematic study involving five gynecologic laparoscopic surgeons.
• Video recording from fixed positions to analyze surgeon stance, posture duration, and limb angles.
• Quantitative analysis of surgical movements and timing.

Main Results:

• Quantitative data on surgical movements were obtained.
• Extreme shoulder abduction angles (up to 61-63.5°) were observed during trocar insertion and instrument manipulation.
• Morcellation procedures involved the most instrument exchanges, while total laparoscopic hysterectomy (TLH) showed neutral elbow positions and myomectomy involved prolonged shoulder abduction.

Conclusions:

• Detailed ergonomic assessment of laparoscopic surgery is achievable in real-time surgical settings.
• This proof-of-concept study highlights the potential for larger studies to identify at-risk movements.
• Findings may inform strategies to control hazardous surgical behaviors and improve surgeon well-being.