Evaluating the Ergonomics of Surgical Residents During Laparoscopic Simulation: A Novel Computerized Approach. 

 -  2023 
<br/><br/>Available online through MWHC library: 2005 - present, Available in print through MWHC library:1999-2007 
<br/><br/> BACKGROUND: Assessment of residents' body positioning during laparoscopy has not been adequately investigated. This study presents a novel computer vision technique to automate ergonomic evaluation and demonstrates this approach through simulated laparoscopy.  CONCLUSIONS: Surgery residents demonstrated suboptimal ergonomics while performing simulated laparoscopic tasks. A novel computer program to measure ergonomics did not agree with the scores generated by the human raters, although it concluded that resident ergonomics remain a concern, especially regarding shoulder and wrist positioning.  METHODS: Surgical residents at a single academic institution were video recorded performing tasks from the Fundamentals of Laparoscopic Surgery (FLS). Ergonomics were assessed by 2 raters using the Rapid Upper Limb Assessment (RULA) tool. Additionally, a novel computer software program was used to measure ergonomics from the video recordings. All participants completed a survey on musculoskeletal complaints, which was graded by severity.  RESULTS: Ten residents participated; all performed FLS in postures that exceeded acceptable ergonomic risks as determined by both the human and computerized RULA scores (P < .001). Lower-level residents scored worse than upper-level residents on the human-graded RULA assessment (P = .04). There was no difference in computer-graded RULA scores by resident level (P = .39) and computer-graded scores did not correlate with human scores (P = .75). Shoulder and wrist position were the greatest contributors to higher computer-graded scores (P < .001). Self-reported musculoskeletal complaints did not differ at resident level (P = .74); however, all residents reported having at least 1 form of musculoskeletal complaint occurring "often." 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0003-1348 
<br/><br/><label>Standard No.: </label>10.1177/00031348211047505 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Internship and Residency<br/>*Laparoscopy<br/>Ergonomics/mt [Methods]<br/>Humans<br/>Upper Extremity--Automated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Heart & Vascular Institute
<br/><br/><label>Index Terms--Occupation: </label><br/>Baltimore
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article