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Learning Curve and Ergonomics Associated with the 3D-monitor-assisted Microsurgery Using a Digital Microscope.

Yuichi Ichikawa¹, Miho Tobita¹, Rina Takahashi²

¹Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Journal of Plastic and Reconstructive Surgery

|May 19, 2025

Summary

This summary is machine-generated.

Digital microscopes offer surgeons modest ergonomic benefits, particularly in reducing muscle fatigue. However, a learning curve exists, with transition times decreasing over time during microsurgery procedures.

Keywords:

3D-monitor-assisted microsurgery digital microscope ergonomics exoscope learning curve

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Area of Science:

Microsurgery
Surgical Technology
Ergonomics

Background:

Three-dimensional monitors and digital microscopes are increasingly used in microsurgery.
Expectations are high for ergonomic advantages, but empirical evidence is limited.
The learning curve and ergonomic benefits compared to conventional optical microscopes require clarification.

Purpose of the Study:

To evaluate the subjective and objective ergonomic advantages of digital microscopes.
To assess the learning curve associated with digital microscope use in microsurgery.
To compare digital microscopes with conventional optical microscopes regarding surgical outcomes and surgeon ergonomics.

Main Methods:

Seventeen head and neck reconstruction cases using digital microscopes were compared to conventional optical microscope cases.
Vascular anastomosis times and microvascular complications were recorded.
Surgeon learning curves were assessed via transition times; objective ergonomics were evaluated using electromyography (EMG) to measure muscle fatigue during simulated anastomosis.

Main Results:

Vascular anastomosis transition times decreased linearly with digital microscope use.
Electromyography revealed ergonomic advantages for surgeons using digital microscopes, specifically reduced fatigue in the lower trapezius muscle.
No mention of microvascular complications or direct comparison of overall surgical outcomes.

Conclusions:

Digital microscopes currently provide moderate ergonomic benefits to surgeons.
A discernible learning period is necessary for surgeons to adapt to digital microscopes.
Further research may be needed to fully quantify long-term benefits and compare efficacy against traditional methods.