Abstract

Surgeons are workers that are particularly prone to the development of musculoskeletal disorders. Recent advances in surgical interventions, such as laparoscopic procedures, have caused a worsening of the scenario, given the harmful static postures that have to be kept for long periods. In this paper, we present a sensor-based platform specifically aimed at monitoring the posture during actual surgical operations. The proposed system adopts a limited number of Inertial Measurement Units (IMUs) to obtain information about spine and neck angles across time. Such a system merges the reliability of sensor-based approaches and the validity of state-of-the-art scoring procedure, such as RULA. Specifically, three IMUs are used to estimate the flexion, lateral bending, and twisting angles of spine and neck. An ergonomic risk index is thus estimated in a time varying fashion borrowing relevant features from the RULA scoring system. The detailed functioning of the proposed systems is introduced, and the assessment results related to a real surgical procedure, consisting of a laparoscopy and mini-laparotomy sections, are shown and discussed. In the exemplary case study introduced, the surgeon kept a high score, indicating the need for an intervention on the working procedures, for a large time fraction. The system allows separately analyzing the contribution of spine and neck, also specifying the angle configuration. It is shown how the proposed approach can provide further information, as related to dynamical analysis, which could be used to enlarge the features taken into account by currently available approaches for ergonomic risk assessment. The proposed system could be adopted both for training purposes, as well as for alerting surgeons during actual surgical operations.

Highlights

  • Musculoskeletal Disorders (MSDs) in workers are a group of diseases affecting muscles, tendons, and nerves and covering a heterogeneous range of health conditions such as lower back pain and upper or lower limb injuries, which have a big impact on the quality of life and productivity [1,2,3]

  • Different from the Rapid Upper Limb Assessment (RULA) index, where a score is obtained for the entire working procedure, the algorithm we developed can be used to estimate a score, which we indicate as the ergonomic risk index, in a time-varying fashion

  • The analysis was performed on two data blocks: the first one is related to the laparoscopy procedure, while the second one is related to the mini-laparotomy procedure

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Summary

Introduction

Musculoskeletal Disorders (MSDs) in workers are a group of diseases affecting muscles, tendons, and nerves and covering a heterogeneous range of health conditions such as lower back pain and upper or lower limb injuries, which have a big impact on the quality of life and productivity [1,2,3]. Surgeons represent a category of workers that are exposed to the risk of developing MSDs during their professional career in comparison with the general population [5]. It has been reported by many cross-sectional studies that up to 80% of physicians, including surgeons and interventionists, manifest evident pain during the surgical procedures, while the prevalence of injuries to the lumbar or cervical spine ranges between 17% and 19% along with the career, with an increase of the observed prevalence.

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