Automated high-frequency posture sampling for ergonomic assessment of laparoscopic surgery

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Abstract
Despite widespread acknowledgement that strain injuries do occur to surgeons, ergonomic assessments in minimally invasive surgery are comparatively rare. Current assessment techniques rely on labor-intensive manual recording techniques, so there is a need for an automated system. We used an optoelectronic measurement system to make postural measurements at frequencies of ~5 Hz and then converted these measurements to ergonomic stress scores using a modified Rapid Upper Limb Assessment (RULA) method. We successfully recorded postures at least once per second during 96% of the time the surgeon was performing tissue manipulation tasks. We found that the ergonomic stress scores were comparatively high throughout the procedure, particularly for the wrist. An automated high-frequency postural measurement system is feasible for making ergonomic assessments in an intraoperative setting. Such a system will also be a critical component in validating surgical simulations for use in training and credentialing surgeons and in designing and evaluating equipment.