ArticleInternational archives of occupational and environmental health2018
An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery: an explorative pilot study.
Article in International archives of occupational and environmental health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- The Use of Wearable Systems for Assessing Work-Related Risks Related to the Musculoskeletal System-A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- Ergonomic evaluation of the Senhance® robotic system in minimally invasive gynecologic procedures versus conventional laparoscopy: an exploratory study focusing on surgeon's muscle activity.Archives of gynecology and obstetrics · 2026Article
- Electromyography in abdominal laparoscopic and robot-assisted laparoscopic surgery: A scoping review.PloS one · 2026Article
- Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery.Sensors (Basel, Switzerland) · 2024Article
- Effect of whole-day work on surgical performance during simulated laparoscopic surgery: study protocol for a controlled cross over laboratory trial.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe interface between surgeon and the laparoscopic instrument is an important factor in biomechanical stress that may increase the risk of musculoskeletal complaints in surgeons. This article investigates the effect of a laparoscopic instrument with a rotatable handle piece (rot-HP) on muscular stress and fatigue during routine laparoscopic procedures (LP) as well as usability, wrist posture and working precision.
methods40 LP (subtotal hysterectomies) performed by 11 surgeons were investigated. 20 LP were carried out with the rot-HP and 20 with a fixed (standard) laparoscopic handle piece instrument. Shoulder and arm muscle activity was monitored via surface electromyography (sEMG). The electrical activity (EA) and median power frequency (MPF) were used to determine muscular stress and fatigue. Usability, wrist posture, and working precision between handle piece conditions were assessed by a survey.
resultsUsing the rot-HP did not reduce muscular stress. A tendency of muscular fatigue (increasing EA, decreasing MPF) occurred in the upper trapezius, middle deltoid and extensor digitorum muscles; however, no differences were found between handle pieces. Wrist posture was more comfortable using the rot-HP and working precision and usability tended to be preferred using the standard handle piece.
conclusionsAlthough wrist posture seemed to be optimized by the rot-HP, no effect on muscular stress and fatigue was observed in routine LP (< 60 min duration). Optimization of wrist posture may provide positive effects in mid- or long-term procedures. However, sufficient familiarization with the new instrument is crucial since working precision and usability could be impaired.
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Registered trials
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