Abstract
Physical discomfort has been frequently reported in surgery, and previous studies have focused on surgeon postures and posture movements. The aim of this study is to develop a methodology and collect pilot data that can be used to test the hypothesis that static work requirements during microsurgery exceed published endurance capabilities and are a source of surgeon fatigue. Eight microsurgery surgeons were analyzed for this study. An event-based time study was performed for the entire duration of the microsurgery. Posture was quantified using ten frames randomly sampled from two surgeons using 3D Static Strength Prediction Program, and outputs were used to calculate endurance limits and maximal acceptable effort. Results found that 83% of microsurgery is performed with the microscope. Posture adjustments were highest during rest (5.5 adjustments per minute) and lowest during microscope task (0.3 adjustments per minute). Back and shoulder postures deviated further from neutral during microscope task than rest. The % MVC in the shoulders and torso have endurance times of 5-57 minutes and exceeded maximum acceptable efforts. Results suggest that the operating microscope constrains surgeon posture and restricts posture adjustments. Microsurgery is predominantly microscope tasks, and endurance capabilities are a concern for surgeon fatigue. Application of current tools to surgery are limited due to the low-force and non-cyclical nature of surgical work; however, these findings can be used to design future studies testing larger surgeon populations and workplace improvements.
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