A. Hanna1, A. Wu2, K. Morris2, S. Liu1 1University Of California – San Diego, School Of Medicine, San Diego, CA, USA 2University Of California – San Diego, Jacobs School Of Engineering, San Diego, CA, USA
Introduction:
Surgeons are prone to ergonomics-related injuries due to the physical and mental stresses of surgery. Over time, these work-related musculoskeletal disorders can threaten the health of surgeons and significantly shorten their career lifespan, ultimately reducing patient access to care. In this study, we developed a novel smartphone app that uses accelerometers in commercially available wireless headphones (AirPod Pro™) and the smartphone to monitor surgeon head position during surgery and provide real-time feedback to correct intraoperative behavior.
Methods:
Surgery attendings and residents were recruited for this trial. They were asked to perform colonoscopy or anorectal surgery while wearing headphones to capture their head position. The specific motions to be captured include extension, flexion, and lateral flexion of the cervical spine. Baseline ergonomic data and performance after real time corrective notification via sound alert through the headphone was evaluated. Audio alerts were triggered after 1-3 seconds of poor ergonomic position was detected. Good ergonomic range was defined as cervical flexion between -15° and 30°. Poor ergonomic range defined as forward flexion between >30° and <45° or <-15° and >-30°.
Results:
Five subjects were recruited performing a total of 11 colonoscopies (6 without alerts, 5 with alerts) and during 13 anorectal surgeries (7 without alerts, 6 with alerts). Surgeons performing colonoscopy without alerts spent 55% of their time in ergonomically unfavorable positions, with 20% in angles exceeding 45°. With the alert system, the time spent in poor ergonomic positions dropped to 21%, with only 6% in angles exceeding 45°. Additionally, surgeons using alerts spent 55% of their time in the optimal range of -15° to 30°, compared to 35% without alerts. Similarly, surgeons spent 54% of the time in ergonomically unfavorable positions while performing anorectal surgery without alert and only 20% with alert. Surgeons with alerts spent 66% of the time in the optimal range of -15° to 30°, compared to 43% without alerts.
Conclusion:
By using a smartphone app and commercially available wireless headphones, we are able to identify and correct surgeon ergonomics in real time relating to head and neck position. The headphones have the added benefit of already being available to nearly all surgeons without the need to purchase additional dedicated personal ergonomic equipment. The effectiveness of the alert system in promoting better ergonomic practices highlights its potential to mitigate injury risks in demanding surgical environments. Further efforts are underway to expand the utilization of this technology to other clinical practices.