Usability and postural benefits of passive back-support exoskeletons in vascular surgery: A preliminary study

The awkward trunk postures such as static flexion and twisting required of surgeons in the operating room are a major contributing factor to the high prevalence of work-related musculoskeletal disorders amongst surgeons. One intervention that is currently proposed to reduce the strain associated with awkward intraoperative postures are passive exoskeletons worn intraoperatively. In this study, we measured the intraoperative postures, subjective discomfort, and workload as well as the usability associated with two commercially available exoskeletons during three types of vascular surgery and compared the results between a baseline (not using exoskeleton) and two different trunk exoskeletons (Laevo and HeroWear). A linear mixed model found that while the exoskeletons did not significantly interfere with surgical workflow, use of the exoskeletons did not significantly affect intraoperative trunk postures (28° vs. 27° vs. 34°, p > .05), subjective discomfort change (2.0 vs. 1.25 vs. 1.92, p = .807 in the low back) (3.00 vs. 1.58 vs. 2.58, p = .454 in the upper back), and (3.00 vs. 2.75 vs. 1.92, 0.153 overall fatigue change), or workload in vascular surgeons. Further research on the effectiveness of exoskeletons in vascular surgeons in reducing discomfort and ergonomic risk factors is recommended.