Presentation
SE4 - Spatiotemporal Assessment of Cataract Surgery for Ergonomics and Workflow – A Case Study
SessionPoster Session 1
DescriptionObjective: The specific aims of this work was to 1) examine the spatiotemporal relationship between an ophthalmologist performing phacoemulsification cataract surgery and their surroundings in a case study, 2) use postural modeling to identify key postures and individual anthropometric measurements that can lead to potential biomechanic fatigue risk for surgeon, 3) apply reach envelopes for surgeon and assisting team members to identify shared workflow envelopes, and 4) provide a framework for integrating work modeling into ergonomic training, education, and interventions. Background: Much of ophthalmologic procedures require the use of microscopes. When performing surgeries with microscopes, surgeons often would adapt extreme neck, torso, shoulder, and arm postures in dictated by their environment (surgical table set up, hand/arm rests, chairs, microscope eye piece, etc.,). As a result, many surgeons report body pain and discomfort both during their surgical procedures, as well as pain and discomfort becoming chronic. This potentially leads to long-term, irreversible Work-Related Musculoskeletal Disorders (WMSDs), as well as a decrease in surgeon’s career longevity and performance. Methods: A single phacoemulsification cataract surgery was analyzed as a case study. First, a shared reach envelope analyses was performed between the surgeon and assistant. Next, different surgical postures observed within the case were then modeled using AutoCAD. These postures were then used to perform load pattern and fatigue assessments using 3D Static Strength Prediction Program (3DSSPP). Variations in potential surgeon anthropometries were examined to determine if individual body sizes made a difference on potential fatigue risks. Results: When analyzing the shared workspace envelope between the surgeon and the assistant, it was found that there was sufficient proximity between the two for communication and tool exchange even if both individuals were of 5th percentile female statures. However, it should be noted that the overlap of the shared workspace envelope will increase significantly with surgeons and assistants of larger statures; perhaps with 95th percentile male anthropometries, the overlap will no longer allow the two to work together synergistically. Examining the postures experienced by the surgeon during phacoemulsification process, the key postural hazards come from twisting motions, as well as sustained leaning motions. It was found that the recommended sustained duration limits for the hip and back in these observed postures are less than 9 minutes. Conclusion: Using a case study, a spatiotemporal model was created to demonstrate key postures experienced by the surgeon over time, allow for risky postures to be identified. In addition, a shared workplace envelope demonstrated a significant amount of overlap between the reaches of the surgeon and assistant. The key limitation in this current work is that it has only been applied to one case study. To strengthen the generalizability of work modeling, future work needs to build a taxonomy of surgical steps utilized within each surgical procedure by developing a standardized work procedure with feedback from surgeons. This will allow for analysis of workflow independent of observation and for any analysis to be done proactively. The major takeaway is that the use of spatiotemporal human modeling is a tool that should be integrated into ergonomics training and education. It can allow for risky postures to be identified so that potential interventions (such as micro-breaks, stretching, exoskeletons, etc.,) can be incorporated into the operating room. In addition, by illustrating the shared workspaces between the surgeon, potential tool sharing, and communication barriers can be identified and addressed.
Event Type
Poster Presentation
TimeMonday, March 314:45pm - 6:15pm EDT
LocationFrontenac Foyer
Digital Health (DH)
Simulation and Education (SE)
Hospital Environments (HE)
Medical and Drug Delivery Devices (MDD)
Patient Safety and Research Initiatives (PS)