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. 2020 May;62(3):377-390.
doi: 10.1177/0018720819879271. Epub 2019 Oct 8.

Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room

Jackie S Cha  1 , Sara Monfared  2 , Dimitrios Stefanidis  2 , Maury A Nussbaum  3 , Denny Yu  1
Affiliations

Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room

Jackie S Cha et al. Hum Factors. 2020 May.

Abstract

Objective: The objective of this study was to identify potential needs and barriers related to using exoskeletons to decrease musculoskeletal (MS) symptoms for workers in the operating room (OR).

Background: MS symptoms and injuries adversely impact worker health and performance in surgical environments. Half of the surgical team members (e.g., surgeons, nurses, trainees) report MS symptoms during and after surgery. Although the ergonomic risks in surgery are well recognized, little has been done to develop and sustain effective interventions.

Method: Surgical team members (n = 14) participated in focus groups, performed a 10-min simulated surgical task with a commercial upper-body exoskeleton, and then completed a usability questionnaire. Content analysis was conducted to determine relevant themes.

Results: Four themes were identified: (1) characteristics of individuals, (2) perceived benefits, (3) environmental/societal factors, and (4) intervention characteristics. Participants noted that exoskeletons would benefit workers who stand in prolonged, static postures (e.g., holding instruments for visualization) and indicated that they could foresee a long-term decrease in MS symptoms with the intervention. Specifically, raising awareness of exoskeletons for early-career workers and obtaining buy-in from team members may increase future adoption of this technology. Mean participant responses from the System Usability Scale was 81.3 out of 100 (SD = 8.1), which was in the acceptable range of usability.

Conclusion: Adoption factors were identified to implement exoskeletons in the OR, such as the indicated need for exoskeletons and usability. Exoskeletons may be beneficial in the OR, but barriers such as maintenance and safety to adoption will need to be addressed.

Application: Findings from this work identify facilitators and barriers for sustained implementation of exoskeletons by surgical teams.

Keywords: industrial/workplace ergonomics; interventions; qualitative methods; surgical care and procedural technologies; usability testing and evaluation.

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Figures

Figure 1.
Figure 1.
(a) Exoskeleton equipment was worn while performing the FLS task, and (b) inside-the-box view of the FLS task. FLS = Fundamentals of Laparoscopic Surgery.
See this image and copyright information in PMC

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