Lakomek Antonia, Eichler Theda, Meyer Moritz, Höing Benedikt, Dudda Marcel, Lang Stephan, Arweiler-Harbeck Diana
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):119-125. doi: 10.1007/s00405-024-08899-0. Epub 2024 Aug 22.
Musculoskeletal complaints and fatigue are commonly described symptoms in daily work of ear nose and throat surgeons using a microscope. Long ear surgical procedures are associated with prolonged microscope use, which can lead to unconsciously tense and uncomfortable body posture. The digital microscope RoboticScope allows visualization of surgical site through a Head-Mounted Display, independent from camera head and is therefore much easier on the back, as the sitting position can be adjusted flexibly. Aim of the prospective study was to investigate to what extent the use of a RoboticScope changes the tension of neck and shoulder muscles of the surgeons in comparison to a conventional tripod microscope.
For this purpose, the electric activity of neck and shoulder muscles of surgeons was recorded using surface electromyography during cochlear implantations. Electrical potentials were derived via electrodes on neck and shoulder muscles. The basic tension of those muscles was measured in relaxed position before and after surgery. During microscope use the tension was continued to be measured. A questionnaire recorded parameters such as level of difficulty of operation as well as patient data.
Results from 58 operations, 33 of which were performed using a conventional microscope and 25 using a Head-Mounted Display, show a significant reduction in muscular tension during surgery by 40% (p < 0.001) in experienced ear surgeons when using a RoboticScope, regardless of the surgeon.
Our results are in line with the relevance of preventive measures to avoid acute and chronic work-related illnesses/symptoms described in literature.
肌肉骨骼方面的不适和疲劳是耳鼻喉科医生在日常显微镜下工作中常见的症状描述。长时间的耳部手术与长时间使用显微镜相关,这可能导致不自觉地紧张和不舒服的身体姿势。数字显微镜RoboticScope可通过头戴式显示器实现手术部位的可视化,独立于摄像头,因此对背部压力小得多,因为坐姿可以灵活调整。这项前瞻性研究的目的是调查与传统三脚架显微镜相比,使用RoboticScope在多大程度上改变了外科医生颈部和肩部肌肉的紧张程度。
为此,在人工耳蜗植入过程中,使用表面肌电图记录外科医生颈部和肩部肌肉的电活动。通过颈部和肩部肌肉上的电极获取电位。在手术前后的放松位置测量这些肌肉的基础张力。在使用显微镜期间持续测量张力。一份问卷记录了诸如手术难度水平以及患者数据等参数。
58例手术的结果显示,无论外科医生是谁,经验丰富的耳科医生在使用RoboticScope进行手术时,肌肉张力在手术期间显著降低了40%(p < 0.001),其中33例使用传统显微镜进行,25例使用头戴式显示器进行。
我们的结果与文献中描述的避免急性和慢性工作相关疾病/症状的预防措施的相关性一致。