Feasibility of an Exoskeleton Armrest to Improve Ergonomics during Endoscopic Sinus and Skull Base Surgery

• Published in: The Laryngoscope 2024-01, Vol.134 (1), p.79-86
• Main Authors: Lobo, David, Sancibrian, Ramon, Mesones, Angela, Llata, José Ramón, Williams, Monica, Viera‐Artiles, Jaime
• Format: Article
• Language: English
• Subjects: endoscopic sinus surgery; endoscopic skull base surgery; Endoscopy; ergonomic; Ergonomics; exoskeleton; Exoskeleton Device; Fatigue; Feasibility Studies; Humans; Pain; Skull Base - surgery; surgeon injury; Surgeons; Surgery; United States
• ISSN: 0023-852X; 1531-4995; 1531-4995
• DOI: 10.1002/lary.30790

Objective The main objective of this study was to develop and evaluate the feasibility and effectiveness of a novel exoskeleton system designed to provide ergonomic assistance to surgeons while preserving or improving the quality of endoscopic sinus and skull base surgical procedures. Methods To evaluate the functionality and ergonomic characteristics of the device, five experiments were conducted in different and increasingly realistic scenarios: silicone model of the nasal cavity, freshly frozen cadavers and finally in a real surgery. Each volunteer's task was recorded and timed. The National Aeronautics and Space Administration Task Load Index (NASA‐TLX) rating scale was used to estimate the surgeons' workload while performing the tasks. Results Twenty‐five volunteers took part in the experiments. Volunteers perceived more comfort and less fatigue and pain when using the armrest than when not using the device (3.3, SD 1.75 vs. 5.9 SD 1.49; p = 0.02). Participants found the device intuitive, comfortable, and improving accuracy and stability with endoscope use. Conclusion A new system that provides ergonomic assistance to surgeons was tested in simulation surgery with acceptable usability. Initial results in terms of pain and fatigue reduction and efficiency were excellent, justifying further research into this technology. Level of Evidence NA Laryngoscope, 134:79–86, 2024 This study examined the feasibility of reducing work‐related pain in Endoscopic Sinus and Skull Base surgeons by using a forearm support. The initial results in terms of pain and fatigue reduction and efficacy were excellent, justifying further research into this technology.