Abstract
Musculoskeletal disorders (MSDs) represent a cross-cutting problem among healthcare workers; particular attention should be given to surgeons who are involved in mentally and physically demanding tasks. This work aimed to propose a multi-parametric ergonomic approach able to exploit different wearable devices to estimate cervical discomfort and the muscular fatigue sustained by an otolaryngology (ENT) surgeon during the execution of laryngeal surgeries. The proposed protocol includes the use of both inertial measurement units (IMUs) and surface electromyography (EMG) probes to monitor head movement and muscle activation during the surgical procedures. IMUs were placed on the forehead and at the C7 level, while EMG probes were positioned on relevant bilateral upper body muscles involved in the surgical tasks. Data analysis encompassed the extraction and examination of flexion/extension, bending, and axial rotation joint angles and EMG signals were scrutinized to assess muscle activation and fatigue. The proposed protocol was preliminary validated involving one expert surgeon, who realized 28 surgeries, employing either a conventional microscope or an advanced exoscope; the setup was well-tolerated, with only minor discomfort reported. The protocol effectively captured detailed information regarding head movement and muscle activation patterns throughout the surgeries, revealing notable features in surgical approaches. The ergonomic assessment protocol provides a solid foundation for future investigations and the development of tailored surgical training programs aimed at mitigating the risk of MSDs among surgeons.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Epstein, S., et al.: Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists. JAMA Surg. 153, e174947 (2018). https://doi.org/10.1001/jamasurg.2017.4947
Yang, L., Wang, T., Weidner, T.K., Madura, J.A., Morrow, M.M., Hallbeck, M.S.: Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery. Surg. Endosc. 35, 6335–6343 (2021). https://doi.org/10.1007/s00464-020-08085-3
Abbruzzese, K., et al.: Physical and mental demand during total hip arthroplasty. Orthop. Clin. North Am. 53, 413–419 (2022). https://doi.org/10.1016/j.ocl.2022.06.005
Galaiya, R., Kinross, J., Arulampalam, T.: Factors associated with burnout syndrome in surgeons: a systematic review. Ann. R. Coll. Surg. England 102, 401–407 (2020). https://doi.org/10.1308/rcsann.2020.0040
Storey, B., Verkerk, M., Hashtroudi, A., Golding-Wood, D.: A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons. J. Laryngol. Otol. 136, 622–627 (2022)
Szeto, G.P.Y., Ho, P., Ting, A.C.W., Poon, J.T.C., Cheng, S.W.K., Tsang, R.C.C.: Work-related musculoskeletal symptoms in surgeons. J. Occup. Rehabil. 19, 175–184 (2009). https://doi.org/10.1007/s10926-009-9176-1
Bolduc-Bégin, J., Prince, F., Christopoulos, A., Ayad, T.: Work-related musculoskeletal symptoms amongst otolaryngologists and head and neck surgeons in Canada. Eur. Arch. Otorhinolaryngol. 275, 261–267 (2018). https://doi.org/10.1007/s00405-017-4787-1
Giagio, S., Volpe, G., Pillastrini, P., Gasparre, G., Frizziero, A., Squizzato, F.: A preventive program for work-related musculoskeletal disorders among surgeons. Ann. Surg. 270, 969–975 (2019). https://doi.org/10.1097/SLA.0000000000003199
Dianat, I., Bazazan, A., Souraki Azad, M.A., Salimi, S.S.: Work-related physical, psychosocial and individual factors associated with musculoskeletal symptoms among surgeons: implications for ergonomic interventions. Appl. Ergon. 67, 115–124 (2018). https://doi.org/10.1016/j.apergo.2017.09.011
Choi, H.S., In, H.: The effects of operating height and the passage of time on the end-point performance of fine manipulative tasks that require high accuracy. Front. Physiol. 13, 944866 (2022). https://doi.org/10.3389/fphys.2022.944866
Chen, T., Dailey, S.H., Naze, S.A., Jiang, J.J.: The head-mounted microscope. Laryngoscope 122, 781–784 (2012). https://doi.org/10.1002/lary.21877
Statham, M.M., Sukits, A.L., Redfern, M.S., Smith, L.J., Sok, J.C., Rosen, C.A.: Ergonomic analysis of microlaryngoscopy. Laryngoscope 120, 297–305 (2010). https://doi.org/10.1002/lary.20686
Maxner, A., Gray, H., Vijendren, A.: A Systematic review of biomechanical risk factors for the development of work-related musculoskeletal disorders in surgeons of the head and neck. Work 69, 247–263 (2021). https://doi.org/10.3233/WOR-213474
Ferlito, S., et al.: High definition three-dimensional exoscope (VITOM 3D) in E.N.T. surgery: a systematic review of current experience. J. Clin. Med. 11, 3639 (2022). https://doi.org/10.3390/jcm11133639
Carlucci, C., Fasanella, L., Maccarini, A.R.: Exolaryngoscopy: a new technique for laryngeal surgery. Acta Otorhinolaryngol. Ital. 32, 326–328 (2012)
Chebib, E., Benoit, C., Bois, E., Teissier, N., Van Den Abbeele, T.: New surgical frontiers for 4k 3D-exoscope in paediatric head and neck surgery. Eur. Arch. Otorhinolaryngol. 280, 2033–2041 (2023). https://doi.org/10.1007/s00405-022-07785-x
Hansson, G.-Å., et al.: Questionnaire versus direct technical measurements in assessing postures and movements of the head, upper back, arms and hands. Scand. J. Work Environ. Health 27, 30–40 (2001). https://doi.org/10.5271/sjweh.584
Arrighi-Allisan, A.E., et al.: Ergonomic analysis of functional endoscopic sinus surgery using novel inertial sensors. Laryngoscope 132, 1153–1159 (2022). https://doi.org/10.1002/lary.29796
Meltzer, A.J., et al.: Measuring ergonomic risk in operating surgeons by using wearable technology. JAMA Surg. 155, 444 (2020). https://doi.org/10.1001/jamasurg.2019.6384
Thurston, T., et al.: Assessment of muscle activity and fatigue during laparoscopic surgery. Surg. Endosc. 36, 6672–6678 (2022). https://doi.org/10.1007/s00464-021-08937-6
Solnik, S., DeVita, P., Rider, P., Long, B., Hortobágyi, T.: Teager-Kaiser operator improves the accuracy of EMG onset detection independent of signal-to-noise ratio. Acta Bioeng. Biomech. 10, 65–68 (2008)
Whittaker, R.L., La Delfa, N.J., Dickerson, C.R.: Algorithmically detectable directional changes in upper extremity motion indicate substantial myoelectric shoulder muscle fatigue during a repetitive manual task. Ergonomics 62, 431–443 (2019). https://doi.org/10.1080/00140139.2018.1536808
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Sala, E. et al. (2023). Proposal of a Multi-parametric Ergonomic Assessment Protocol Integrating Intra-operative Use of Wearable Technology to Evaluate Musculoskeletal Discomfort for Surgeon During Laryngeal Surgery. In: Duffy, V.G., Krömker, H., A. Streitz, N., Konomi, S. (eds) HCI International 2023 – Late Breaking Papers. HCII 2023. Lecture Notes in Computer Science, vol 14057. Springer, Cham. https://doi.org/10.1007/978-3-031-48047-8_9
Download citation
DOI: https://doi.org/10.1007/978-3-031-48047-8_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-48046-1
Online ISBN: 978-3-031-48047-8
eBook Packages: Computer ScienceComputer Science (R0)