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Which causes more ergonomic stress: Laparoscopic or open surgery?
Robert Wang1, Zhe Liang1, Ahmed M Zihni2
1Department of Surgery, Section of Minimally Invasive Surgery, Washington University in St Louis, St Louis, MO, USA.
Surgical Endoscopy
|December 8, 2016
Summary
Laparoscopic surgery reduces upper-body muscle strain compared to open procedures, contrary to initial hypotheses. This study quantifies ergonomic differences, finding significant muscle activation reductions in laparoscopic surgery for key upper body muscles.
Area of Science:
- Surgical Ergonomics
- Minimally Invasive Surgery
- Occupational Health
Background:
- Growing awareness of ergonomic challenges faced by laparoscopic surgeons.
- Need to quantify and compare surgeon ergonomic stress between open and laparoscopic procedures.
- Hypothesis: Laparoscopic surgery causes greater ergonomic stress than open surgery.
Purpose of the Study:
- To quantify and compare ergonomic stress in open versus laparoscopic surgery.
- To measure upper-body muscle activation during different surgical approaches.
- To evaluate the impact of surgical technique on surgeon physical strain.
Main Methods:
- Electromyography (EMG) used to measure muscle activation in biceps, triceps, deltoid, and trapezius.
- Study involved five sigmoid colectomy cases with both open and laparoscopic components.
- EMG data normalized to maximum voluntary contraction (%MVC) and compared between surgical phases.
Main Results:
- Laparoscopic procedures showed significant reductions in muscle activation compared to open procedures.
- Reductions observed in left triceps (35%), left deltoid (46%), left trapezius (54%), right triceps (37%), and right trapezius (54%).
- Findings contradict the initial hypothesis regarding increased laparoscopic surgical stress.
Conclusions:
- Laparoscopic approach offers ergonomic benefits for upper-body muscles compared to open surgery.
- Potential reasons include enhanced instrument reach and reduced impact of patient body habitus.
- Further research with larger cohorts and diverse procedures is recommended.
