PD41-07 ERGONOMICS IN THE OR: AN ELECTROMYELOGRAPHIC EVALUATION OF COMMON MUSCLE GROUPS USED DURING SIMULATED FLEXIBLE URETEROSCOPY

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (PD41)1 Sep 2021PD41-07 ERGONOMICS IN THE OR: AN ELECTROMYELOGRAPHIC EVALUATION OF COMMON MUSCLE GROUPS USED DURING SIMULATED FLEXIBLE URETEROSCOPY George Gheordunescu, Kyle O'Laughlin, Alec Sun, Juan Fulla, Naveen Kachroo, Henry Wright, and Smita De George GheordunescuGeorge Gheordunescu More articles by this author , Kyle O'LaughlinKyle O'Laughlin More articles by this author , Alec SunAlec Sun More articles by this author , Juan FullaJuan Fulla More articles by this author , Naveen KachrooNaveen Kachroo More articles by this author , Henry WrightHenry Wright More articles by this author , and Smita DeSmita De More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002051.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ergonomics in flexible ureteroscopy is poorly understood. We sought to assess the effects of different surgeon positions (sitting vs. standing) and ureteroscope types (disposable vs. non-disposable) on muscle activation as measured on electromyography (EMG) during ureteroscopy in an endourology box-trainer model and kidney phantom. METHODS: For this exploratory study, EMG was used to quantify muscle activation of three endourologists during various ureteroscopic tasks. Surface EMG electrodes (ADInstruments, Colorado Springs, CO) were placed on the scope-holding side of the following muscle groups: thenar, forearm flexor, forearm extensor, biceps, triceps, deltoid, and trapezius. “Real world” operative settings were re-created: subjects wore fitted lead aprons in an operating room suite and used a cystoscopy table with surgical drapes and an endoscopic video tower. Subjects completed each trial while sitting and standing, and while using a disposable and non-disposable scope. Each subject performed an identical set of tasks in a phantom silicone kidney and ureteroscopy box trainer used to recreate the procedural components of dusting, basketing, and navigating a renal collecting system. Raw EMG data for each task was processed and normalized as a percent of each subject’s maximum voluntary contraction (MVC) to allow comparison. The EMG activity of all subjects and tasks were compiled (Figure 1). Tasks were analyzed individually and then in aggregate because muscle activation trends were similar and a complete set of tasks better represented a ureteroscopy procedure. RESULTS: The forearm extensor was the most heavily utilized muscle regardless of posture or scope type. The trapezius muscle was activated more during sitting vs. standing. The forearm extensor muscle was activated more with the heavier non-disposable scope vs. the disposable scope. CONCLUSIONS: Our preliminary data show differences in muscle activation based on both surgical posture and type of scope used. This highlights the need for larger and more extensive EMG studies to identify techniques and equipment to optimize ergonomics and potentially minimize repetitive use injury during flexible ureteroscopy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e683-e683 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information George Gheordunescu More articles by this author Kyle O'Laughlin More articles by this author Alec Sun More articles by this author Juan Fulla More articles by this author Naveen Kachroo More articles by this author Henry Wright More articles by this author Smita De More articles by this author Expand All Advertisement Loading ...