Intraoperative Electromyogram Analysis of Postural Musculature With Three-dimensional Screen Display Versus Operating...

Area of Science:

• Ophthalmology
• Surgical Technology
• Ergonomics

Background:

• Ophthalmic surgery traditionally uses operating microscopes (TOM).
• Concerns exist regarding surgeon posture and potential spinal pathology from TOM use.
• Three-dimensional screen-based surgery (3D SBS) presents an alternative technology.

Purpose of the Study:

• To compare the impact of 3D SBS versus TOM on surgeon's posterior chain postural musculature.
• To evaluate surgical ergonomics and their relation to cervical and lumbar spine health.
• To hypothesize increased muscle activation with TOM compared to 3D SBS.

Main Methods:

• Electromyography (EMG) surface electrodes were placed on key postural muscles.
• Data collected across sessions using both 3D SBS and TOM in a crossover design.
• Surgeon comfort surveys administered pre- and post-surgery and daily.

Main Results:

• EMG revealed increased muscle activation in most measured muscles when using TOM compared to 3D SBS.
• Anterior deltoids and one quadratus lumborum muscle showed no significant difference in activation.
• Surveys indicated greater surgeon fatigue with TOM use.

Conclusions:

• EMG data confirm higher postural muscle activation with TOM compared to 3D SBS.
• Survey results align with previous findings, suggesting poorer ergonomics with TOM.
• 3D SBS may offer an ergonomic advantage in ophthalmic surgery.