Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Urology, University of Michigan Medical School, Ann Arbor, MI, USA.
Obes Surg. 2019 Jun;29(6):1709-1713. doi: 10.1007/s11695-019-03748-0.
Minimally invasive surgery may introduce new ergonomic challenges for surgeons. Increased patient body mass index (BMI) may further add to this ergonomic stress.
The objective of this study was to quantify the ergonomic impact of patient BMI on surgeons during laparoscopic surgery.
University Hospital, USA.
This prospective cohort study analyzed five minimally invasive surgeons during 24 laparoscopic procedures. Each subject's muscle stress was assessed by recording surface electromyography (EMG) data from eight upper body muscle groups during laparoscopic procedures. EMG data was normalized against the maximal voluntary contraction (MVC) of each muscle measured before the start of surgery to create a percentage of the MVC value (%MVC). Subject workload was assessed through the NASA Task Load Index (NTLX). Statistical analysis was used to determine significance between surgeons operating on patients with or without obesity for %MVC and NTLX scores.
There was no significant difference (p > 0.05) in both the average muscle activation of all eight muscle groups and NTLX scores during laparoscopic surgery in surgeons operating on patients with BMI > = 30 compared with patients with a BMI < 30.
We detected no differences in ergonomic stress or workload for surgeons operating on patients with or without obesity. For surgeons, the laparoscopic approach may offer an additional advantage over open surgery in patients with obesity. This advantage may be due to an "equalizing effect" of laparoscopy-that surgical ergonomics are less affected by the BMI of the patient when using laparoscopic tools.
微创手术可能会给外科医生带来新的人体工程学挑战。患者体重指数（BMI）的增加可能会进一步增加这种人体工程学压力。
本研究的目的是量化患者 BMI 对腹腔镜手术中外科医生的人体工程学影响。
美国大学医院。
这项前瞻性队列研究分析了 24 例腹腔镜手术中的 5 名微创外科医生。每位受试者的肌肉应激通过记录腹腔镜手术过程中 8 个上半身肌肉群的表面肌电图（EMG）数据来评估。EMG 数据通过将手术开始前测量的每个肌肉的最大自主收缩（MVC）与 EMG 数据进行归一化，以创建 MVC 值的百分比（%MVC）。通过 NASA 任务负荷指数（NTLX）评估受试者的工作负荷。使用统计分析来确定在 BMI≥30 的患者和 BMI<30 的患者之间进行手术的外科医生的%MVC 和 NTLX 评分之间的差异是否具有统计学意义。
在 BMI≥30 的患者和 BMI<30 的患者之间进行手术的外科医生的平均 8 个肌肉群的肌肉激活和 NTLX 评分之间没有显著差异（p>0.05）。
我们没有发现对 BMI≥30 和 BMI<30 的患者进行手术的外科医生的人体工程学压力或工作负荷有差异。对于外科医生来说，与开放手术相比，腹腔镜手术可能在肥胖患者中提供了额外的优势。这种优势可能归因于腹腔镜的“均衡效应”，即使用腹腔镜工具时，手术的人体工程学受患者 BMI 的影响较小。
