A case-study comparison of qualitative and quantitative techniques for assessing surgeon ergonomics

Evan R. Johnson, Syed A. Husain, S. Lavender, Carolyn M. Sommerich
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Abstract

Surgeons are often exposed to many ergonomic risk factors during open, laparoscopic, and robotic-assisted surgical procedures, which lead to pain or discomfort in alarmingly high percentages of surgeons. Ergonomic risk factors specific to colon and rectal surgery subspecialty have been hypothesized, but little research has been done on this topic. To investigate this, an ergonomics-centered case study was performed with an experienced colon and rectal surgeon at a teaching hospital to investigate their experiences with surgery, ergonomics, and musculoskeletal pain. Specifically, a semi-structured interview was performed with the participant, and skin surface electromyography electrodes were placed on the participant to record muscle activity data as they performed rectal surgeries using open, laparoscopic, and robotic-assisted surgical techniques. The results of this case study indicate that for this participant, robotic surgery may provide the most relief from current pain and discomfort; however, the relationship between muscle activation and surgical modality is complex, and both qualitative and quantitative methods are needed to provide a complete ergonomic analysis of colon and rectal surgery in a teaching hospital setting.
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用于评估外科医生人体工程学的定性和定量技术的案例研究比较
在开腹、腹腔镜和机器人辅助手术过程中,外科医生经常会面临许多人体工程学风险因素,导致外科医生出现疼痛或不适的比例高得惊人。结肠和直肠外科亚专业特有的人体工程学风险因素已被提出,但这方面的研究却很少。为了研究这个问题,我们对一家教学医院经验丰富的结肠和直肠外科医生进行了一项以人体工程学为中心的案例研究,以调查他们在手术、人体工程学和肌肉骨骼疼痛方面的经验。具体来说,研究人员对受试者进行了半结构化访谈,并在受试者身上放置了皮肤表面肌电图电极,以记录他们在使用开放式、腹腔镜和机器人辅助手术技术进行直肠手术时的肌肉活动数据。本病例研究的结果表明,对该受试者而言,机器人手术可以最大程度地缓解其目前的疼痛和不适;但是,肌肉激活与手术方式之间的关系非常复杂,需要同时采用定性和定量方法,才能对教学医院环境中的结肠和直肠手术进行完整的人体工程学分析。
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