Departments of Ophthalmology.
Rehabilitation Medicine, and.
Retina. 2022 Aug 1;42(8):1583-1591. doi: 10.1097/IAE.0000000000003482.
To quantitatively analyze surgical ergonomics between standard operating microscope (SOM) and digitally assisted vitreoretinal surgery (DAVS) systems.
The surgeon conducted procedures on 110 patients; 52 patients underwent a combined phacoemulsification and pars plana vitrectomy (Phaco-PPV group, 24 using SOM and 28 using DAVS), and 58 patients underwent phacoemulsification (Phaco group, 30 using SOM and 28 using DAVS). The surgeon's muscle tone and stiffness in the sternocleidomastoid and the two positions of the upper trapezius (UT), which are 2-cm intervals along the UT muscle fibers, UT1 and UT2, were measured at preoperative, intraoperative, and postoperative time points.
In the Phaco-PPV group using the SOM, intraoperative muscle tone and stiffness were higher than preoperative and postoperative values in the sternocleidomastoid ( P < 0.001, respectively), UT1 ( P < 0.001, respectively), and UT2 ( P < 0.001 and P < 0.01, respectively). In the Phaco group using the SOM, intraoperative muscle tone and stiffness were higher than pre- and postoperative values in the sternocleidomastoid ( P < 0.001, respectively) and UT1 ( P < 0.001 and P < 0.01, respectively). By contrast, when the surgeon used the DAVS, there were no differences in muscle properties at any measurement site or during any time point in the Phaco-PPV and Phaco groups ( P > 0.05).
This study provides quantitative measurement of retina surgeon ergonomics, suggesting that compared with a SOM, the DAVS can reduce intraoperative muscle fatigue.
定量分析标准手术显微镜(SOM)和数字化辅助玻璃体视网膜手术(DAVS)系统之间的手术工效学。
医生对 110 名患者进行了手术;52 名患者接受了白内障超声乳化联合经平坦部玻璃体切除术(Phaco-PPV 组,24 例使用 SOM,28 例使用 DAVS),58 名患者接受了白内障超声乳化术(Phaco 组,30 例使用 SOM,28 例使用 DAVS)。在术前、术中及术后时间点,测量了颈斜肌和上斜方肌(UT)两个位置(UT 肌纤维上每隔 2cm 测量一次)的肌肉张力和僵硬度。
在使用 SOM 的 Phaco-PPV 组中,术中颈斜肌、UT1 和 UT2 的肌肉张力和僵硬度均高于术前和术后(P<0.001)。在使用 SOM 的 Phaco 组中,术中颈斜肌和 UT1 的肌肉张力和僵硬度均高于术前和术后(P<0.001)。而当医生使用 DAVS 时,在 Phaco-PPV 和 Phaco 两组中,在任何测量部位或任何时间点,肌肉特性均无差异(P>0.05)。
本研究提供了视网膜外科医生工效学的定量测量,表明与 SOM 相比,DAVS 可减少术中肌肉疲劳。