A Comprehensive Methodology for Assessing Biomechanical Risks Associated with Hand Tool Use: Applied to Laparoscopic Surgical Instruments

Biomechanical risk factors are physical stressors that act on the neuromuscular structures of the human body and are present in all occupational settings. Repetition and intensity of tasks performed can magnify the effects of the biomechanical risks that a worker is exposed to. After reviewing the current literature on ergonomics in laparoscopic surgery it was clear that a comprehensive approach to quantitatively reporting on the biomechanical risk factors associated with surgical hand tools had never been performed. Utilizing an opto-electronic motion capture system meant the exact surgeon posture was recorded during simulated surgical tasks. Electromyography was used to evaluate muscle recruitment and workload for small forearm muscles used in wrist stabilization. Point-force sensors were used to evaluate grip and actuation forces that occurred while using various laparoscopic medical devices. The force plate gathered information on subject center of pressure location as well as moment and friction forces that resulted from push, pull, and twisting motions of hand-held devices. Taking a comprehensive approach to ergonomics created new possibilities for advancements in device and workplace design, directly benefitting the end user. Correlating data between different research modalities has resulted in new information with regards to the biomechanical influences devices impose on the user or surgeons in this particular application. Taking steps to mitigate the risks involved with hand tool use can potentially lower drop-out rates from work related neuromuscular symptoms, increase career longevity and subsequently increase the size of the experienced workforce