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Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors.
Laryngoscope. 2022 06; 132(6):1153-1159.L

Abstract

OBJECTIVES/HYPOTHESIS

Suboptimal ergonomics during endoscopic sinus surgery can lead to considerable physical discomfort and fatigue for the surgeon. The purpose of this pilot study is to objectively evaluate the ergonomic positions of trainee and attending surgeons while performing functional endoscopic sinus surgery (FESS).

STUDY DESIGN

Pilot prospective trial.

METHODS

Six surgeons (two attendings and four trainees) performed FESS while wearing 11 inertial measurement units (IMUs) affixed to either side of each major joint. Screen placement was standardized to be 1 m directly in front of the surgeon and on the patient's left, 0-15° declined from the surgeons' eyes. Bed height was standardized such that the workspace was 0 to 10 cm below the elbows. IMU data were analyzed to calculate joint angles. Ideal joint angles (i.e., <10° for neck and trunk) were determined by the validated Rapid Entire Body Assessment tool. Subjects subsequently completed a modified National Aeronautics and Space Administration Task Load Index to assess cognitive and physical burden and pain. Student's t-test was employed to detect differences between groups.

RESULTS

Trainees adopted positions involving significantly greater neck flexion (9.90° vs. -6.48°, P = .03) and reported significantly higher frustration levels (3.04 vs. 1.33, P = .02) while operating than attendings. For both cohorts, increased operative time was significantly correlated with greater back flexion (r = 0.90, P = .02; r = 0.55, P = .04, respectively).

CONCLUSIONS

Our data suggest that trainees operate with higher risk neck postures than do attendings. These data indicate high-risk operative postures may be borne of inexperience and present an opportunity for postural interventions at an early stage of training.

LEVEL OF EVIDENCE

NA Laryngoscope, 132:1153-1159, 2022.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Arrighi-Allisan AE

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

MeSH

ErgonomicsHumansOccupational DiseasesPilot ProjectsProspective StudiesSurgeons

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34355793

Citation

Arrighi-Allisan, Annie E., et al. "Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors." The Laryngoscope, vol. 132, no. 6, 2022, pp. 1153-1159.

Arrighi-Allisan AE, Garvey KL, Wong A, et al. Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors. Laryngoscope. 2022;132(6):1153-1159.

Arrighi-Allisan, A. E., Garvey, K. L., Wong, A., Filip, P., Shah, J., Spock, T., Del Signore, A., Cosetti, M. K., Govindaraj, S., & Iloreta, A. M. (2022). Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors. The Laryngoscope, 132(6), 1153-1159. https://doi.org/10.1002/lary.29796

Arrighi-Allisan AE, et al. Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors. Laryngoscope. 2022;132(6):1153-1159. PubMed PMID: 34355793.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors. AU - Arrighi-Allisan,Annie E, AU - Garvey,Katherine L, AU - Wong,Anni, AU - Filip,Peter, AU - Shah,Janki, AU - Spock,Todd, AU - Del Signore,Anthony, AU - Cosetti,Maura K, AU - Govindaraj,Satish, AU - Iloreta,Alfred Marc, Y1 - 2021/08/06/ PY - 2021/07/07/revised PY - 2021/03/30/received PY - 2021/07/17/accepted PY - 2021/8/7/pubmed PY - 2022/5/18/medline PY - 2021/8/6/entrez KW - FESS KW - Posture KW - ergonomics KW - physician health KW - rhinology SP - 1153 EP - 1159 JF - The Laryngoscope JO - Laryngoscope VL - 132 IS - 6 N2 - OBJECTIVES/HYPOTHESIS: Suboptimal ergonomics during endoscopic sinus surgery can lead to considerable physical discomfort and fatigue for the surgeon. The purpose of this pilot study is to objectively evaluate the ergonomic positions of trainee and attending surgeons while performing functional endoscopic sinus surgery (FESS). STUDY DESIGN: Pilot prospective trial. METHODS: Six surgeons (two attendings and four trainees) performed FESS while wearing 11 inertial measurement units (IMUs) affixed to either side of each major joint. Screen placement was standardized to be 1 m directly in front of the surgeon and on the patient's left, 0-15° declined from the surgeons' eyes. Bed height was standardized such that the workspace was 0 to 10 cm below the elbows. IMU data were analyzed to calculate joint angles. Ideal joint angles (i.e., <10° for neck and trunk) were determined by the validated Rapid Entire Body Assessment tool. Subjects subsequently completed a modified National Aeronautics and Space Administration Task Load Index to assess cognitive and physical burden and pain. Student's t-test was employed to detect differences between groups. RESULTS: Trainees adopted positions involving significantly greater neck flexion (9.90° vs. -6.48°, P = .03) and reported significantly higher frustration levels (3.04 vs. 1.33, P = .02) while operating than attendings. For both cohorts, increased operative time was significantly correlated with greater back flexion (r = 0.90, P = .02; r = 0.55, P = .04, respectively). CONCLUSIONS: Our data suggest that trainees operate with higher risk neck postures than do attendings. These data indicate high-risk operative postures may be borne of inexperience and present an opportunity for postural interventions at an early stage of training. LEVEL OF EVIDENCE: NA Laryngoscope, 132:1153-1159, 2022. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/34355793/Ergonomic_Analysis_of_Functional_Endoscopic_Sinus_Surgery_Using_Novel_Inertial_Sensors_ DB - PRIME DP - Unbound Medicine ER -