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CC BY-NC-ND 4.0 · J Reconstr Microsurg 2023; 39(06): 453-461
DOI: 10.1055/s-0042-1758188
Original Article

Intraoperative Ergonomic Assessment of Exoscopes versus Conventional DIEP Flap

Tianke Wang
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
,
Hamid Norasi
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
2   Division of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota
,
Minh-Doan Nguyen
3   Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Christin Harless
3   Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Katherine E. Law
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
2   Division of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota
,
Tianqi G. Smith
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
,
Emmanuel Tetteh
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
2   Division of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota
,
Susan Hallbeck
1   Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
2   Division of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota
3   Department of Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Funding This study was funded by a research grant from Olympus, which included a loan of equipment. Olympus had no involvement in the study execution or interpretation of results.
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Abstract

Background This study compared the ergonomics of surgeons during deep inferior epigastric perforator (DIEP) flap surgery using either baseline equipment (loupes, headlights, and an operating microscope) or an exoscope. Plastic surgeons may be at high risk of musculoskeletal problems. Recent studies indicate that adopting an exoscope may significantly improve surgeon postures and ergonomics.

Methods Postural exposures, using inertial measurement units at the neck, torso, and shoulders, were calculated in addition to the surgeons' subjective physical and cognitive workload. An ergonomic risk score on a scale of 1 (lowest) to 4 (highest) was calculated for each of the postures observed. Data from 23 bilateral DIEP flap surgeries (10 baseline and 13 exoscope) were collected.

Results The neck and torso risk scores decreased significantly during abdominal flap harvest and chest dissection, while right shoulder risk scores increased during the abdominal flap harvest for exoscope DIEP flap procedures compared with. Exoscope anastomoses demonstrated higher neck, right shoulder, and left shoulder risk scores. The results from the survey for the “surgeon at abdomen” showed that the usage of exoscopes was associated with decreased performance and increased mental demand, temporal demand, and effort. However, the results from the “surgeon at chest” showed that the usage of exoscopes was associated with lower physical demand and fatigue, potentially due to differences in surgeon preference.

Conclusion Our study revealed some objective evidence for the ergonomic benefits of exoscope; however, this is dependent on the tasks the surgeon is performing. Additionally, personal preferences may be an important factor to be considered in the ergonomic evaluation of the exoscope.

Keywords

exoscope - plastic surgery - ergonomics - postural exposure - inertial measurement unit

Disclosures

Olympus had no involvement in the study execution or interpretation of results.




Publication History

Received: 19 April 2022

Accepted: 17 September 2022

Article published online:
12 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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