Proposal of a Multi-parametric Ergonomic Assessment Protocol Integrating Intra-operative Use of Wearable Technology to Evaluate Musculoskeletal Discomfort for Surgeon During Laryngeal Surgery

Musculoskeletal disorders (MSDs) represent a cross-cutting problem among healthcare workers; particular attention should be given to surgeons who are involved in mentally and physically demanding tasks. This work aimed to propose a multi-parametric ergonomic approach able to exploit different wearable devices to estimate cervical discomfort and the muscular fatigue sustained by an otolaryngology (ENT) surgeon during the execution of laryngeal surgeries. The proposed protocol includes the use of both inertial measurement units (IMUs) and surface electromyography (EMG) probes to monitor head movement and muscle activation during the surgical procedures. IMUs were placed on the forehead and at the C7 level, while EMG probes were positioned on relevant bilateral upper body muscles involved in the surgical tasks. Data analysis encompassed the extraction and examination of flexion/extension, bending, and axial rotation joint angles and EMG signals were scrutinized to assess muscle activation and fatigue. The proposed protocol was preliminary validated involving one expert surgeon, who realized 28 surgeries, employing either a conventional microscope or an advanced exoscope; the setup was well-tolerated, with only minor discomfort reported. The protocol effectively captured detailed information regarding head movement and muscle activation patterns throughout the surgeries, revealing notable features in surgical approaches. The ergonomic assessment protocol provides a solid foundation for future investigations and the development of tailored surgical training programs aimed at mitigating the risk of MSDs among surgeons.