Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P030: INGUINAL HERNIA REPAIR WITH MESH: THE IMPACT ON SURGEONS PERFORMING ROBOTIC-ASSISTED, LAPAROSCOPY, AND OPEN SURGERIES
Laura Flores, BA; Jared Baxter, BS; Ka-Chun Siu, PhD; Priscila Rodrigues Armijo, MD; University of Nebraska Medical Center
Introduction: The benefits of inguinal hernia repairs with mesh are well established in the literature, but mesh fixation can be a difficult and time-consuming procedure, with unclear impacts on occupational injury. Our aim was to evaluate whether surgical approach has different impact on musculoskeletal injuries of surgeons performing inguinal hernia repair with mesh fixation.
Methods: Two surgeons performing open (OPEN), laparoscopic (LAP), and robotic-assisted (ROBOT) inguinal hernia repair with mesh at a single-institution were enrolled. Muscle activation of both upper limbs was recorded during surgical procedure using Delsys Trigno wireless surface electromyography (EMG). Two surgical subtasks were analyzed: placement of mesh and mesh fixation. The following muscle groups were evaluated: upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis (FCR), and extensor digitorum (ED). The maximal voluntary contraction (MVC) was obtained to normalize root-mean-square muscle activation as %MVCRMS. The median frequency (MDF) was calculated to assess muscle fatigue. Each surgeon also completed the validated Piper Fatigue Scale-12 (PFH-12) before and after the procedure for self-perceived fatigue assessment. The Rapid Entire Body Assessment (REBA) was used for the assessment of risk of musculoskeletal injuries. Descriptive analyses were performed using the SPSS v26.0.
Results: Preliminary data of four surgeries were collected (OPEN: N=1, LAP: N=1, ROBOT: N=2). All surgeons were right-handed. EMG analysis revealed a trend for the OPEN approach to have a higher activation for left UT (%MVCRMS=35.27%), versus LAP (%MVCRMS=2.11%) and ROBOT (%MVCRMS=5.25%). A spike was seen in the activation of right ED muscle group during mesh fixation in the LAP approach (%MVCRMS=24.28%). In general, muscle groups of shoulder had a lower activation than wrist muscle groups for the LAP and ROBOT approaches, but not in the OPEN approach. REBA scores revealed ROBOT approach to present low risk for musculoskeletal injury (Score:3), whereas LAP presented with medium risk (Score:5). Self-reported fatigue was similar before and after the surgery within each surgical approach.
Conclusions: Although statistical significance was not evaluated in the current data, due to the limited sample size, our preliminary analysis revealed interesting findings. UT tended to show higher activation in the OPEN approach for both surgical tasks evaluated. LAP and ROBOT approaches had similar trends in muscle activation for all group muscle studied, regardless of right or left arm. On-going research comprises the collection of additional data for the current project and to account for surgeon’s height, patient’s waist circumference, and duration of surgery. Additionally, we will evaluate the 6-month impact of surgeries on surgeons’ report of musculoskeletal injury.
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