Abstract
During microsurgical procedures, manipulations are often performed using a foot switch while the surgeon stands on one foot. This position can easily result in body axis instability and greater musculoskeletal loading. To support the surgeon’s posture, we have developed a tool called the “Surgeon’s Body Support Device.” The objective of this study was to determine the efficacy of this device by analyzing surgeons’ kinematics and musculoskeletal loading during simulated operations undertaken while standing. Fourteen surgeons volunteered to perform simulations of surgery while standing. To analyze motion kinetics and musculoskeletal loading with and without this device, a three-axis accelerometer and surface electromyography (SEMG) sensors were attached to the subjects. Compared with not using the supportive device, the axis of the surgeon’s body was significantly more stable when the support device was used (P = .001). The evenness of motion also tended to be superior when the device was utilized (P = .009). Simulations performed using the device significantly reduced the musculoskeletal loading on the ventral side of the left foot by 70 % compared with simulations performed not using the device (P = .001). Data from SEMG sensor placed on the right hand, which performs the surgical manipulations, indicated that simulations performed using the device generated approximately 10 % of the musculoskeletal load generated when the device was not used (P = .001). The Surgeon’s Body Support Device appears to improve maneuverability and reduce musculoskeletal loading during simulated surgical procedures undertaken while standing.
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Acknowledgments
We thank Mr. S Okada of MicroStone Corporation; Mr. S Ono, Mr. D Tachikawa, and Ms. E Ayaka of Ammtec Inc.; and Mr. F Kurata, Mr. K Nakamura, and Mr. T Ikeda of Takano Co., Ltd. for their technical support during this study.
Conflict of interest
No financial xsupport was provided for this study. Takano Co., Ltd. played no part in the data analysis, interpretation, or in writing this manuscript. The authors have no personal or institutional conflicts of interest to declare.
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Yavor Enchev, Varna, Bulgaria
The manuscript of Ito et al. represents an intriguing paper as it addressed the problem of surgeon’s stability and fatigue during neurosurgical procedures performed while standing. In order to find a solution for the problem, they developed a tool called the Surgeon’s Body Support Device. The authors evaluated the efficacy of their device by analyzing neurosurgeons’ kinematics and musculoskeletal loading during simulated procedures underwent while standing. The study included 14 volunteer surgeons, who were supplied with a three-axis accelerometer and surface electromyography sensors. The results with and without the use of the proposed device were compared. Based on their results, the authors concluded that the Surgeon’s Body Support Device improves maneuverability and reduces musculoskeletal loading during simulated surgical procedures undertaken while standing. The study has an excellent design and it is perfectly performed. Finally, I hope that this device will be soon available and affordable for the neurosurgeons worldwide.
Ihsan Solaroglu, Istanbul, Turkey
Neurosurgery is a stressful field. A neurosurgeon must have mental and physical stamina. However, the cumulative effect of chronic stress in our practice often results in burnout which has serious consequences such as poor job performance and decreased productivity. The physical workload, the numbers of call nights per week, and long working hours negatively affect the health of a neurosurgeon. In our daily practice, many of the procedures take hours to complete, and as stated by Ito et al., most of them are conducted while standing. Body axis instability and greater musculoskeletal loading during operations decrease maneuverability and also create a potential risk for musculoskeletal disorders for us. I believe every effort directed at the protection of the health and wellness of the neurosurgeon is worthwhile.
The Surgeon’s Body Support Device, developed by Ito et al., is a candidate device, which may meet requirements and may be used in our daily practice. However, in this study, the data came from only simulated operations. I strongly recommend performing real procedures by using Surgeon’s Body Support Device to explore whether this will provide better comfort for surgeons. Also, the effect of this device on patient outcomes should be evaluated in long term.
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Ito, K., Horiuchi, T., Seguchi, T. et al. Usefulness of a device for body support during operations performed while standing. Neurosurg Rev 38, 731–737 (2015). https://doi.org/10.1007/s10143-015-0633-3
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DOI: https://doi.org/10.1007/s10143-015-0633-3