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Effect of Patient Body Mass Index on Laparoscopic Surgical Ergonomics

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Abstract

Background

Minimally invasive surgery may introduce new ergonomic challenges for surgeons. Increased patient body mass index (BMI) may further add to this ergonomic stress.

Objectives

The objective of this study was to quantify the ergonomic impact of patient BMI on surgeons during laparoscopic surgery.

Setting

University Hospital, USA.

Methods

This prospective cohort study analyzed five minimally invasive surgeons during 24 laparoscopic procedures. Each subject’s muscle stress was assessed by recording surface electromyography (EMG) data from eight upper body muscle groups during laparoscopic procedures. EMG data was normalized against the maximal voluntary contraction (MVC) of each muscle measured before the start of surgery to create a percentage of the MVC value (%MVC). Subject workload was assessed through the NASA Task Load Index (NTLX). Statistical analysis was used to determine significance between surgeons operating on patients with or without obesity for %MVC and NTLX scores.

Results

There was no significant difference (p > 0.05) in both the average muscle activation of all eight muscle groups and NTLX scores during laparoscopic surgery in surgeons operating on patients with BMI > = 30 compared with patients with a BMI < 30.

Conclusions

We detected no differences in ergonomic stress or workload for surgeons operating on patients with or without obesity. For surgeons, the laparoscopic approach may offer an additional advantage over open surgery in patients with obesity. This advantage may be due to an “equalizing effect” of laparoscopy—that surgical ergonomics are less affected by the BMI of the patient when using laparoscopic tools.

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Acknowledgements

This work was supported by the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) [2012] and Intuitive, Surgical Inc. [2013].

Funding

This work was supported by the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) [2012] and Intuitive, Surgical Inc. [2013].

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Author notes

  1. Zhe Liang and William D. Gerull contributed equally to the writing of this manuscript.

Authors and Affiliations

  1. Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Zhe Liang, William D. Gerull, Ahmed Zihni, Shuddhadeb Ray & Michael Awad

  2. Urology, University of Michigan Medical School, Ann Arbor, MI, USA

    Robert Wang

Authors
  1. Zhe Liang
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  2. William D. Gerull
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  3. Robert Wang
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  4. Ahmed Zihni
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  5. Shuddhadeb Ray
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  6. Michael Awad
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Corresponding author

Correspondence to William D. Gerull.

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Liang, Z., Gerull, W.D., Wang, R. et al. Effect of Patient Body Mass Index on Laparoscopic Surgical Ergonomics. OBES SURG 29, 1709–1713 (2019). https://doi.org/10.1007/s11695-019-03748-0

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  • DOI: https://doi.org/10.1007/s11695-019-03748-0

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