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Solving the surgeon ergonomic crisis with surgical exosuit.
Surg Endosc. 2018 Jan; 32(1):236-244.SE

Abstract

INTRODUCTION

The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery.

METHODS AND PROCEDURES

This is a prospective randomized crossover study approved by the Internal Review Board (IRB). The study involves three phases of testing. In each phase, general surgery residents or attendings were randomized to wearing the surgical exosuit at the beginning or at the crossover point. The first phase tests for surgeon manual dexterity wearing the device using the Minnesota Dexterity test, the Purdue Pegboard test, and the Fundamentals of Laparoscopic Surgery (FLS) modules. The second phase tests the effect of the device on shoulder pain and fatigue while operating the laparoscopic camera. The third phase rates surgeon experience in the operating room between case-matched operating days.

RESULTS

Twenty subjects were recruited for this study. Surgeons had the similar dexterity scores and FLS times whether or not they wore the exosuit (p value ranges 0.15-0.84). All exosuit surgeons completed 15 min of holding laparoscopic camera compared to three non-exosuit surgeons (p < 0.02). Exosuit surgeons experienced significantly less fatigue at all time periods and arm pain (3.11 vs 5.88, p = 0.019) at 10 min. Surgeons wearing the exosuit during an operation experienced significant decrease in shoulder pain and 85% of surgeons reported some form of pain reduction at the end of the operative day.

CONCLUSION

The progressive arm support exosuit can be a minimally intrusive device that laparoscopic surgeons wear to reduce pain and fatigue of surgery without significantly interfering with operative skills or manual dexterity.

Authors+Show Affiliations

Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA. s5liu@ucsd.edu.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.Center for the Future of Surgery, Department of Surgery, University of California at San Diego, 200 W. Arbor Drive, #8220, San Diego, CA, 92103, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28643066

Citation

Liu, Shanglei, et al. "Solving the Surgeon Ergonomic Crisis With Surgical Exosuit." Surgical Endoscopy, vol. 32, no. 1, 2018, pp. 236-244.
Liu S, Hemming D, Luo RB, et al. Solving the surgeon ergonomic crisis with surgical exosuit. Surg Endosc. 2018;32(1):236-244.
Liu, S., Hemming, D., Luo, R. B., Reynolds, J., Delong, J. C., Sandler, B. J., Jacobsen, G. R., & Horgan, S. (2018). Solving the surgeon ergonomic crisis with surgical exosuit. Surgical Endoscopy, 32(1), 236-244. https://doi.org/10.1007/s00464-017-5667-x
Liu S, et al. Solving the Surgeon Ergonomic Crisis With Surgical Exosuit. Surg Endosc. 2018;32(1):236-244. PubMed PMID: 28643066.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Solving the surgeon ergonomic crisis with surgical exosuit. AU - Liu,Shanglei, AU - Hemming,Daniel, AU - Luo,Ran B, AU - Reynolds,Jessica, AU - Delong,Jonathan C, AU - Sandler,Bryan J, AU - Jacobsen,Garth R, AU - Horgan,Santiago, Y1 - 2017/06/22/ PY - 2017/03/23/received PY - 2017/06/07/accepted PY - 2017/6/24/pubmed PY - 2019/3/8/medline PY - 2017/6/24/entrez KW - Ergonomic KW - Exoskeleton KW - Laparoscopic surgery KW - Surgeon injury SP - 236 EP - 244 JF - Surgical endoscopy JO - Surg Endosc VL - 32 IS - 1 N2 - INTRODUCTION: The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery. METHODS AND PROCEDURES: This is a prospective randomized crossover study approved by the Internal Review Board (IRB). The study involves three phases of testing. In each phase, general surgery residents or attendings were randomized to wearing the surgical exosuit at the beginning or at the crossover point. The first phase tests for surgeon manual dexterity wearing the device using the Minnesota Dexterity test, the Purdue Pegboard test, and the Fundamentals of Laparoscopic Surgery (FLS) modules. The second phase tests the effect of the device on shoulder pain and fatigue while operating the laparoscopic camera. The third phase rates surgeon experience in the operating room between case-matched operating days. RESULTS: Twenty subjects were recruited for this study. Surgeons had the similar dexterity scores and FLS times whether or not they wore the exosuit (p value ranges 0.15-0.84). All exosuit surgeons completed 15 min of holding laparoscopic camera compared to three non-exosuit surgeons (p < 0.02). Exosuit surgeons experienced significantly less fatigue at all time periods and arm pain (3.11 vs 5.88, p = 0.019) at 10 min. Surgeons wearing the exosuit during an operation experienced significant decrease in shoulder pain and 85% of surgeons reported some form of pain reduction at the end of the operative day. CONCLUSION: The progressive arm support exosuit can be a minimally intrusive device that laparoscopic surgeons wear to reduce pain and fatigue of surgery without significantly interfering with operative skills or manual dexterity. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/28643066/Solving_the_surgeon_ergonomic_crisis_with_surgical_exosuit_ DB - PRIME DP - Unbound Medicine ER -