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An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery: an explorative pilot study.
Int Arch Occup Environ Health. 2018 Nov; 91(8):1021-1029.IA

Abstract

PURPOSE

The interface between surgeon and the laparoscopic instrument is an important factor in biomechanical stress that may increase the risk of musculoskeletal complaints in surgeons. This article investigates the effect of a laparoscopic instrument with a rotatable handle piece (rot-HP) on muscular stress and fatigue during routine laparoscopic procedures (LP) as well as usability, wrist posture and working precision.

METHODS

40 LP (subtotal hysterectomies) performed by 11 surgeons were investigated. 20 LP were carried out with the rot-HP and 20 with a fixed (standard) laparoscopic handle piece instrument. Shoulder and arm muscle activity was monitored via surface electromyography (sEMG). The electrical activity (EA) and median power frequency (MPF) were used to determine muscular stress and fatigue. Usability, wrist posture, and working precision between handle piece conditions were assessed by a survey.

RESULTS

Using the rot-HP did not reduce muscular stress. A tendency of muscular fatigue (increasing EA, decreasing MPF) occurred in the upper trapezius, middle deltoid and extensor digitorum muscles; however, no differences were found between handle pieces. Wrist posture was more comfortable using the rot-HP and working precision and usability tended to be preferred using the standard handle piece.

CONCLUSIONS

Although wrist posture seemed to be optimized by the rot-HP, no effect on muscular stress and fatigue was observed in routine LP (< 60 min duration). Optimization of wrist posture may provide positive effects in mid- or long-term procedures. However, sufficient familiarization with the new instrument is crucial since working precision and usability could be impaired.

Authors+Show Affiliations

Centre of Women's Health, University Hospital Tuebingen, Calwerstraβe 7, 72076, Tuebingen, Germany.Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraβe 27, 72074, Tuebingen, Germany.Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraβe 27, 72074, Tuebingen, Germany.Centre of Women's Health, University Hospital Tuebingen, Calwerstraβe 7, 72076, Tuebingen, Germany. Women's Center Bern, Bremgartenstrasse 119, 3012, Bern, Switzerland.Centre of Women's Health, University Hospital Tuebingen, Calwerstraβe 7, 72076, Tuebingen, Germany.Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraβe 27, 72074, Tuebingen, Germany.Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraβe 27, 72074, Tuebingen, Germany. benjamin.steinhilber@med.uni-tuebingen.de.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

30078157

Citation

Kraemer, Bernhard, et al. "An Ergonomic Field Study to Evaluate the Effects of a Rotatable Handle Piece On Muscular Stress and Fatigue as Well as Subjective Ratings of Usability, Wrist Posture and Precision During Laparoscopic Surgery: an Explorative Pilot Study." International Archives of Occupational and Environmental Health, vol. 91, no. 8, 2018, pp. 1021-1029.
Kraemer B, Seibt R, Stoffels AK, et al. An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery: an explorative pilot study. Int Arch Occup Environ Health. 2018;91(8):1021-1029.
Kraemer, B., Seibt, R., Stoffels, A. K., Rothmund, R., Brucker, S. Y., Rieger, M. A., & Steinhilber, B. (2018). An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery: an explorative pilot study. International Archives of Occupational and Environmental Health, 91(8), 1021-1029. https://doi.org/10.1007/s00420-018-1344-1
Kraemer B, et al. An Ergonomic Field Study to Evaluate the Effects of a Rotatable Handle Piece On Muscular Stress and Fatigue as Well as Subjective Ratings of Usability, Wrist Posture and Precision During Laparoscopic Surgery: an Explorative Pilot Study. Int Arch Occup Environ Health. 2018;91(8):1021-1029. PubMed PMID: 30078157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery: an explorative pilot study. AU - Kraemer,Bernhard, AU - Seibt,Robert, AU - Stoffels,Anne-Katrin, AU - Rothmund,Ralf, AU - Brucker,Sara Y, AU - Rieger,Monika A, AU - Steinhilber,Benjamin, Y1 - 2018/08/04/ PY - 2017/07/14/received PY - 2018/07/27/accepted PY - 2018/8/6/pubmed PY - 2019/2/14/medline PY - 2018/8/6/entrez KW - Laparoscopic surgery KW - Muscular fatigue KW - Muscular stress KW - Usability KW - sEMG SP - 1021 EP - 1029 JF - International archives of occupational and environmental health JO - Int Arch Occup Environ Health VL - 91 IS - 8 N2 - PURPOSE: The interface between surgeon and the laparoscopic instrument is an important factor in biomechanical stress that may increase the risk of musculoskeletal complaints in surgeons. This article investigates the effect of a laparoscopic instrument with a rotatable handle piece (rot-HP) on muscular stress and fatigue during routine laparoscopic procedures (LP) as well as usability, wrist posture and working precision. METHODS: 40 LP (subtotal hysterectomies) performed by 11 surgeons were investigated. 20 LP were carried out with the rot-HP and 20 with a fixed (standard) laparoscopic handle piece instrument. Shoulder and arm muscle activity was monitored via surface electromyography (sEMG). The electrical activity (EA) and median power frequency (MPF) were used to determine muscular stress and fatigue. Usability, wrist posture, and working precision between handle piece conditions were assessed by a survey. RESULTS: Using the rot-HP did not reduce muscular stress. A tendency of muscular fatigue (increasing EA, decreasing MPF) occurred in the upper trapezius, middle deltoid and extensor digitorum muscles; however, no differences were found between handle pieces. Wrist posture was more comfortable using the rot-HP and working precision and usability tended to be preferred using the standard handle piece. CONCLUSIONS: Although wrist posture seemed to be optimized by the rot-HP, no effect on muscular stress and fatigue was observed in routine LP (< 60 min duration). Optimization of wrist posture may provide positive effects in mid- or long-term procedures. However, sufficient familiarization with the new instrument is crucial since working precision and usability could be impaired. SN - 1432-1246 UR - https://www.unboundmedicine.com/medline/citation/30078157/An_ergonomic_field_study_to_evaluate_the_effects_of_a_rotatable_handle_piece_on_muscular_stress_and_fatigue_as_well_as_subjective_ratings_of_usability_wrist_posture_and_precision_during_laparoscopic_surgery:_an_explorative_pilot_study_ DB - PRIME DP - Unbound Medicine ER -