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Ergonomic analysis of the surgical position in functional endoscopic sinus surgery.
Int Forum Allergy Rhinol. 2017 06; 7(6):570-575.IF

Abstract

BACKGROUND

Ergonomics is the methodologic study of people's efficiency in their work environment and is based on anatomy, physiology, psychology, and engineering. Although highly studied in other work environments, little attention has been paid to surgeons until the landmark survey by Park et al in 2010. Many unique aspects of endoscopic surgery amplify task-related physical discomfort, and, because of these issues, we aimed to study the physical fatigue effects of functional endoscopic sinus surgery (FESS) performed in the standing and sitting positions.

METHODS

Bilateral FESS was performed in 8 cadaver heads (4 in the standing position, 4 in the sitting position), following established ergonomic principles. Physical fatigue was assessed using a 27-point physical discomfort questionnaire, surface electromyography (EMG), and the NASA Task Load Index Survey. Paired and unpaired t tests were used for statistical analysis.

RESULTS

Physical fatigue was noted after FESS performed in both positions. An overall similar task burden was seen when comparing the 2 positions, although the sitting position was more "frustrating" (p < 0.05). Discomfort after FESS in the standing position was worse in the legs and low back, whereas, in the sitting position, it was seen predominantly in the upper back and arms (p < 0.05). Mean power frequency EMG measurements demonstrated fatigue of major muscle groups in both positions.

CONCLUSION

Significant physical fatigue is reported after a single FESS operation, with measurable EMG changes. Surgeons should be aware of the short- and long-term physical implications of their daily tasks, and should use this information to be proactive in decision-making for their longevity.

Authors+Show Affiliations

Department of Otolaryngology, University of Colorado, Aurora, CO. Department of Neurosurgery, University of Colorado, Aurora, CO.Department of Otolaryngology, University of Colorado, Aurora, CO.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28296272

Citation

Ramakrishnan, Vijay R., and Benjamin M. Milam. "Ergonomic Analysis of the Surgical Position in Functional Endoscopic Sinus Surgery." International Forum of Allergy & Rhinology, vol. 7, no. 6, 2017, pp. 570-575.
Ramakrishnan VR, Milam BM. Ergonomic analysis of the surgical position in functional endoscopic sinus surgery. Int Forum Allergy Rhinol. 2017;7(6):570-575.
Ramakrishnan, V. R., & Milam, B. M. (2017). Ergonomic analysis of the surgical position in functional endoscopic sinus surgery. International Forum of Allergy & Rhinology, 7(6), 570-575. https://doi.org/10.1002/alr.21911
Ramakrishnan VR, Milam BM. Ergonomic Analysis of the Surgical Position in Functional Endoscopic Sinus Surgery. Int Forum Allergy Rhinol. 2017;7(6):570-575. PubMed PMID: 28296272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ergonomic analysis of the surgical position in functional endoscopic sinus surgery. AU - Ramakrishnan,Vijay R, AU - Milam,Benjamin M, Y1 - 2017/03/15/ PY - 2016/08/09/received PY - 2016/11/21/revised PY - 2016/12/13/accepted PY - 2017/3/16/pubmed PY - 2018/3/20/medline PY - 2017/3/16/entrez KW - FESS KW - ergonomics KW - sinus surgery KW - sinusitis KW - surgeon fatigue SP - 570 EP - 575 JF - International forum of allergy & rhinology JO - Int Forum Allergy Rhinol VL - 7 IS - 6 N2 - BACKGROUND: Ergonomics is the methodologic study of people's efficiency in their work environment and is based on anatomy, physiology, psychology, and engineering. Although highly studied in other work environments, little attention has been paid to surgeons until the landmark survey by Park et al in 2010. Many unique aspects of endoscopic surgery amplify task-related physical discomfort, and, because of these issues, we aimed to study the physical fatigue effects of functional endoscopic sinus surgery (FESS) performed in the standing and sitting positions. METHODS: Bilateral FESS was performed in 8 cadaver heads (4 in the standing position, 4 in the sitting position), following established ergonomic principles. Physical fatigue was assessed using a 27-point physical discomfort questionnaire, surface electromyography (EMG), and the NASA Task Load Index Survey. Paired and unpaired t tests were used for statistical analysis. RESULTS: Physical fatigue was noted after FESS performed in both positions. An overall similar task burden was seen when comparing the 2 positions, although the sitting position was more "frustrating" (p < 0.05). Discomfort after FESS in the standing position was worse in the legs and low back, whereas, in the sitting position, it was seen predominantly in the upper back and arms (p < 0.05). Mean power frequency EMG measurements demonstrated fatigue of major muscle groups in both positions. CONCLUSION: Significant physical fatigue is reported after a single FESS operation, with measurable EMG changes. Surgeons should be aware of the short- and long-term physical implications of their daily tasks, and should use this information to be proactive in decision-making for their longevity. SN - 2042-6984 UR - https://www.unboundmedicine.com/medline/citation/28296272/Ergonomic_analysis_of_the_surgical_position_in_functional_endoscopic_sinus_surgery_ L2 - https://doi.org/10.1002/alr.21911 DB - PRIME DP - Unbound Medicine ER -