TY - JOUR
T1 - Reducing Surgeon's Physical Stress in Minimally Invasive Neurosurgery
AU - Nakayashiki, Atsushi
AU - Kawaguchi, Tomohiro
AU - Nakagawa, Atsuhiro
AU - Mochizuki, Fusako
AU - Furukawa, Hiroaki
AU - Nagai, Arata
AU - Suematsu, Takuya
AU - Tominaga, Teiji
N1 - Funding Information:
This study was funded in part by a grant from the Japanese Foundation for Research and Promotion of Endoscopy. This work was also supported in part by the Translational Research Network Program, Grant-in-Aid for Scientific Research (A) 15H01707, Grant-in-Aid for Scientific Research (B) 15H04945, 16H04309, and 26282116, Grant-in-Aid for Scientific Research (C) 16K11126, 26462629, 26462197, and 26462196, and Grant-in-Aid for Challenging Exploratory Research 16K15810 and 25670565 from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT). Drs. Naka-gawa and Tominaga received research support for this study from Seiko Epson Co., Ltd., under a collaborative research contract with Tohoku University, and Drs. Kawa-guchi, Nakagawa, and Tominaga are patent holders with Seiko Epson Co., Ltd.
Publisher Copyright:
© 2019 Georg Thieme Verlag. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background and Study Aims âVarious minimally invasive approaches are used in neurosurgery. Surgeons must perform nondynamic fine movements in a narrow corridor, so specially designed surgical devices are essential. Unsophisticated instruments may pose potential hazards. The purpose of this study was to assess the factors associated with muscle fatigue during minimally invasive neurosurgery and to investigate whether physical stress can be reduced by refining the devices used. Material and Methods âFour physical aspects of a handpiece were investigated: Torque of conduits (0.20, 0.28, and 0.37 kgfcm), shape of hand grip (five types), angle of the nozzle (0, 20, and 40 degrees), and weight balance (neutral, proximal, and distal). To evaluate muscle fatigue, surface electromyography was recorded from the extensor carpi radialis muscle and flexor carpi radialis muscle during a geometric tracing task. The maximum voluntary contraction (MVC) of each muscle and %MVC (muscle contraction during a task/MVC × 100) were used as the indexes of muscle fatigue. Results âThe shape of the hand grip significantly reduced %MVC, which is associated with muscle fatigue. The torque of conduits and angle of the nozzle tended to reduce muscle fatigue but not significantly. Weight balance did not affect muscle fatigue. Based on these results, we made two refined models: Model α (torque of conduits 0.2 kgfcm, angle of nozzle 20 degrees, neutral balance, hand grip with a 2.9 × 2.0-cm oval section with angled finger rest), and model β (torque of conduits 0.2 kgfcm, angle of nozzle 20 degrees, neutral balance, hand grip with a 2.9-cm round section with a curved finger rest). The %MVC was significantly decreased with both types (p < 0.05 and p < 0.01, respectively), indicating reduction of muscle fatigue. Conclusions âThe geometrically refined surgical device can improve muscle load during surgery and reduce the surgeon's physical stress, thus minimizing the risk of complications.
AB - Background and Study Aims âVarious minimally invasive approaches are used in neurosurgery. Surgeons must perform nondynamic fine movements in a narrow corridor, so specially designed surgical devices are essential. Unsophisticated instruments may pose potential hazards. The purpose of this study was to assess the factors associated with muscle fatigue during minimally invasive neurosurgery and to investigate whether physical stress can be reduced by refining the devices used. Material and Methods âFour physical aspects of a handpiece were investigated: Torque of conduits (0.20, 0.28, and 0.37 kgfcm), shape of hand grip (five types), angle of the nozzle (0, 20, and 40 degrees), and weight balance (neutral, proximal, and distal). To evaluate muscle fatigue, surface electromyography was recorded from the extensor carpi radialis muscle and flexor carpi radialis muscle during a geometric tracing task. The maximum voluntary contraction (MVC) of each muscle and %MVC (muscle contraction during a task/MVC × 100) were used as the indexes of muscle fatigue. Results âThe shape of the hand grip significantly reduced %MVC, which is associated with muscle fatigue. The torque of conduits and angle of the nozzle tended to reduce muscle fatigue but not significantly. Weight balance did not affect muscle fatigue. Based on these results, we made two refined models: Model α (torque of conduits 0.2 kgfcm, angle of nozzle 20 degrees, neutral balance, hand grip with a 2.9 × 2.0-cm oval section with angled finger rest), and model β (torque of conduits 0.2 kgfcm, angle of nozzle 20 degrees, neutral balance, hand grip with a 2.9-cm round section with a curved finger rest). The %MVC was significantly decreased with both types (p < 0.05 and p < 0.01, respectively), indicating reduction of muscle fatigue. Conclusions âThe geometrically refined surgical device can improve muscle load during surgery and reduce the surgeon's physical stress, thus minimizing the risk of complications.
KW - medical device development
KW - muscle fatigue
KW - pulsed water jet
KW - stress reduction
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U2 - 10.1055/s-0038-1676622
DO - 10.1055/s-0038-1676622
M3 - Article
C2 - 31018225
AN - SCOPUS:85071361115
SN - 2193-6315
VL - 80
SP - 333
EP - 340
JO - Journal of Neurological Surgery, Part A: Central European Neurosurgery
JF - Journal of Neurological Surgery, Part A: Central European Neurosurgery
IS - 5
ER -