Intraoperative Ergonomic Assessment of Exoscopes versus Conventional DIEP Flap

Area of Science:

• Microsurgery and reconstructive surgery
• Surgical ergonomics and technology
• Musculoskeletal health in surgical professions

Background:

• Plastic surgeons face high risks of musculoskeletal issues.
• Baseline equipment includes loupes, headlights, and operating microscopes.
• Exoscopes show potential for improving surgeon posture and ergonomics.

Purpose of the Study:

• To compare the ergonomics of surgeons during deep inferior epigastric perforator (DIEP) flap surgery using baseline equipment versus an exoscope.
• To evaluate objective postural exposures and subjective surgeon workload.

Main Methods:

• Inertial measurement units assessed neck, torso, and shoulder postures.
• Subjective physical and cognitive workload was measured.
• Ergonomic risk scores (1-4) were calculated for observed postures in 23 DIEP flap surgeries.

Main Results:

• Exoscope use decreased neck and torso risk scores during abdominal flap harvest and chest dissection.
• Exoscope use increased right shoulder risk scores during abdominal flap harvest.
• Exoscope use during anastomoses showed higher neck and shoulder risk scores, with mixed subjective feedback on workload.

Conclusions:

• Exoscopes offer objective ergonomic benefits in DIEP flap surgery, task-dependent.
• Surgeon preference significantly influences the perceived ergonomic advantages of exoscopes.
• Further research is needed to optimize exoscope integration for maximal ergonomic benefit.