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International Archives of Occupational and Environmental Health

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04.08.2018 | Original Article

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

verfasst von: Bernhard Kraemer, Robert Seibt, Anne-Katrin Stoffels, Ralf Rothmund, Sara Y. Brucker, Monika A. Rieger, Benjamin Steinhilber

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 8/2018

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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.

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Titel: 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
verfasst von: Bernhard Kraemer
Robert Seibt
Anne-Katrin Stoffels
Ralf Rothmund
Sara Y. Brucker
Monika A. Rieger
Benjamin Steinhilber
Publikationsdatum: 04.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Archives of Occupational and Environmental Health / Ausgabe 8/2018
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-018-1344-1

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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