Muscular workload of veterinary students during simulated open and laparoscopic surgery: A pilot study

摘要

Objective: To compare upper extremity muscle activity and workload between simulated open surgery, multiple port laparoscopic surgery (MLS), and single incision laparoscopic surgery (SLS) techniques in veterinary students. Study design: Pilot study. Population: Veterinary students (n510) from years 1 to 4. Methods: Bipolar skin surface electrodes were fixed bilaterally to the forearm flexor, forearm extensor, biceps brachii, triceps brachii, and upper trapezius muscles. Electromyography data were recorded during one repetition of 2 simulated surgical exercises via open surgery, MLS, and SLS. Participants completed a validated workload survey after each simulated surgical technique. Muscle activity and perceived workload were compared between surgical techniques with 1-way ANOVAs and Fisher's LSD post hoc tests. Results: Muscle activity during peg transfer was higher with MLS and SLS compared to simulated open surgery in the right and left forearm extensors (both P. 0001), right (P. 0001) and left biceps (P=.0005), right triceps (P=.0004), and right upper trapezius muscles (P=.0211). Similar results were found for the right and left forearm extensors (both P. 0001), right (P=.0381) and left (P=.0147) forearm flexors, right biceps (P. 0001), and right triceps (P=.0004) during a simulated suture task. Participants found laparoscopic techniques more mentally demanding, physically demanding, complex, and stressful compared to a simulated open surgical technique. Conclusion: In veterinary students, average muscle activity and perceived workload were highest using MLS and SLS compared to an open surgical technique when performing simulated surgical exercises in a laparoscopic box trainer.