A comparison of thumb and forearm muscle effort required for laparoscopic and open surgery using an ergonomic measurement station

Processed electromyogram (EMG) signals were acquired from 27 subjects while they completed two simulated surgical tasks using first a hemostat, and then an Ethicon/sup (R)/ laparoscopic grasper, with the aid of an endoscopic trainer and video monitoring system. The two tasks were: opening and closing alligator clips, and peeling apart two pieces of Velcro/sup (R)/. Three indices (peak processed EMG, average processed EMG and integrated effort-area under the processed EMG vs. time graph) were used to indicate the physical workload placed on the surgeon during laparoscopic and open surgery. It was found that the indices were significantly (P<0.05) greater for both tasks performed using laparoscopic as opposed to open surgery techniques. These findings indicate that performing tasks using laparoscopic surgical techniques is more taxing on the surgeon.