Division of Convergence Technology, Research Institute of National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
Center for Thyroid Cancer, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
Surg Endosc. 2022 Feb;36(2):988-998. doi: 10.1007/s00464-021-08363-8. Epub 2021 Feb 26.
The aim of this study was to objectively compare medical augmented reality glasses (ARG) and conventional monitors in video-assisted surgery and to systematically analyze its ergonomic benefits.
Three surgeons (thoracic, laparoscopic, and thyroid surgeons) participated in the study. Six thoracoscopic metastasectomies, six subtotal laparoscopic gastrectomies, and six thyroidectomies were performed with and without ARG. The subjective experience was evaluated using a questionnaire-based NASA-Task Load Index (NASA-TLX). Postures during surgeries were recorded. The risk of musculoskeletal disorders associated with video-assisted surgery was assessed using rapid entire body assessment (REBA). Surface electromyography (EMG) was recorded. Muscle fatigue was objectively measured.
NASA-TLX scores of three surgeons were lower when ARG was used compared to those with conventional monitor (66.4 versus 82.7). Less workload during surgery was reported with ARG. The laparoscopic surgeon exhibited a substantial decrease in mental and physical demand [- 21.1 and 12.5%)] and the thyroid surgeon did (- 40.0 and - 66.7%).Total REBA scores decreased with ARG (8 to 3.6). The risk of musculoskeletal disorders was improved in regions of the neck and shoulders. Root mean square (RMS) of the EMG signal decreased from 0.347 ± 0.150 to 0.286 ± 0.130 (p = 0.010) with usage of ARG; a decrease was observed in all surgeons. The greatest RMS decrease was observed in trapezius and sternocleidomastoid muscles. The decrease in brachioradialis muscle was small.
ARG assisted with correction of bad posture in surgeons during video-assisted surgery and reduced muscular fatigue of the upper body. This study highlights the superior ergonomic efficiency of ARG in video-assisted surgery.
本研究旨在客观比较医学增强现实眼镜（ARG）和传统监视器在视频辅助手术中的应用，并系统分析其在人体工程学方面的优势。
三位外科医生（胸外科、腹腔镜外科和甲状腺外科医生）参与了这项研究。六例胸腔镜转移切除术、六例腹腔镜胃大部切除术和六例甲状腺切除术分别采用和不采用 ARG 进行。使用基于 NASA 任务负荷指数（NASA-TLX）的问卷调查评估主观体验。记录手术中的姿势。使用快速全身评估（REBA）评估与视频辅助手术相关的肌肉骨骼疾病风险。记录表面肌电图（EMG）。客观测量肌肉疲劳。
与使用传统监视器相比，三位外科医生使用 ARG 时的 NASA-TLX 评分更低（66.4 比 82.7）。使用 ARG 时报告的手术工作量更小。腹腔镜外科医生的心理和体力需求分别显著降低（-21.1%和-12.5%），甲状腺外科医生的需求也显著降低（-40.0%和-66.7%）。使用 ARG 时总 REBA 评分降低（8 分降至 3.6 分）。颈部和肩部的肌肉骨骼疾病风险得到改善。使用 ARG 时，肌电图信号的均方根（RMS）从 0.347±0.150 降至 0.286±0.130（p=0.010），所有外科医生均观察到下降。斜方肌和胸锁乳突肌的 RMS 下降最大。肱二头肌的 RMS 下降较小。
ARG 有助于在视频辅助手术中纠正外科医生的不良姿势，并减轻上半身的肌肉疲劳。本研究强调了 ARG 在视频辅助手术中的卓越人体工程学效率。
