A Surface Electromyogram Evaluation of the Postural Freedom Effects in Laparoscopic Surgery

Area of Science:

• Minimally Invasive Surgery
• Ergonomics
• Musculoskeletal Health

Background:

• Laparoscopic surgery offers patient benefits but poses ergonomic challenges for surgeons.
• Awkward postures and repetitive movements in laparoscopy contribute to upper limb musculoskeletal disorders.

Purpose of the Study:

• To evaluate and compare muscular activity and fatigue between conventional laparoscopic instruments and those with a novel Postural Freedom (PF) feature.
• To assess the impact of the PF feature on specific surgeon muscles, including trapezius, deltoids, biceps, and flexor carpi radialis.

Main Methods:

• Seventeen participants performed static simulations using both conventional and PF-enabled laparoscopic instruments.
• Surface electromyography (sEMG) measured muscular activity and fatigue in key upper limb muscles across various target positions.

Main Results:

• The PF prototype demonstrated a significant reduction in muscular activity, exceeding 70% in trapezius and deltoid muscles compared to conventional tools.
• Muscular fatigue occurred with both instruments, but the PF prototype showed a lower frequency of fatigue.
• Higher muscular activity was observed at entrance/exit targets and those directly facing the surgeon.

Conclusions:

• Conventional laparoscopic instruments negatively impact surgeon muscular activity and posture.
• The Postural Freedom (PF) feature in laparoscopic instrumentation effectively reduces muscular activity and mitigates fatigue in surgeons.