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Objective assessment of surgeon kinematics during simulated laparoscopic surgery: a preliminary evaluation of the effect of high body mass index models

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journal contribution
posted on 24.03.2022, 09:49 authored by Ryan Sers, Steph ForresterSteph Forrester, Massimiliano ZeccaMassimiliano Zecca, Stephen WardStephen Ward, Esther Moss
Purpose Laparoscopy is used in many surgical specialties. Subjective reports have suggested that performing laparoscopic surgery in patients with a high body mass index (BMI) is leading to increased prevalence of musculoskeletal symptoms in surgeons. The aim of this study was to objectively quantify the impact on surgeon upper body kinematics and dynamic workload when performing simulated laparoscopy at different BMI levels. Methods Upper body kinematics and dynamic workload of novice, intermediate and expert surgeons were calculated based on measurements from inertial measurement units positioned on upper body segments. Varying thicknesses of foam were used to simulate patient BMIs of 20, 30, 40 and 50 kg/m2 during laparoscopic training. Results Significant increases in the jerkiness, angular speed and cumulative displacement of the head, torso and upper arms were found within all experience groups when subject to the 40 and 50 kg/m2 models. Novice surgeons were found to have less controlled kinematics and larger dynamic workloads compared to the more experienced surgeons. Conclusions Our findings indicate that performing laparoscopic surgery on a high BMI model worsens upper body motion efficiency and efficacy, and increases dynamic workload, producing conditions that are more physically demanding when compared to operating on a 20 kg/m2 model. These findings also suggest that the head, torso, and upper arm segments are especially affected by high BMI models and therefore exposure to patients with high BMIs may increase the risk of musculoskeletal injury when performing laparoscopic surgery.

Funding

LU-HEFCE Catalyst Grant

LU-EESE startup grant

Research Studentship by the Doctoral College of Loughborough University, UK

History

School

  • Mechanical, Electrical and Manufacturing Engineering

Published in

International Journal of Computer Assisted Radiology and Surgery

Volume

17

Issue

1

Pages

75 - 83

Publisher

Springer

Version

VoR (Version of Record)

Rights holder

© The Authors

Publisher statement

This is an Open Access Article. It is published by Springer under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

Acceptance date

06/07/2021

Publication date

2021-07-24

Copyright date

2021

ISSN

1861-6410

eISSN

1861-6429

Language

en

Depositor

Prof Massimiliano Zecca. Deposit date: 23 March 2022