Abstract：
(1) Background: Surgeons are exposed to musculoskeletal loads that are comparable to those of industrial workers. These stresses are harmful for the joints and muscles and can lead to musculoskeletal disorders (MSD) and working incapacity for surgeons. In this paper, we propose a novel ergonomic and visualization approach to assess muscular fatigue during surgical procedures. (2) Methods: The activity of eight muscles from the shoulder girdle and the cervical/lumbar spines were evaluated using position and electromyographic wearable sensors while a surgeon performed an arthroscopic rotator-cuff surgery on a patient. The time and frequency-domain variables of the root-mean-square amplitude and mean power frequency, respectively, were calculated from an electromyographic signal. (3) Results: The entire surgical procedure lasted 73 min and was divided into 10 sub-phases associated with specific level of muscular activity and fatigue. Most of the muscles showed activity above 60%, while the middle trapezius muscles were almost constantly activated (>20%) throughout the surgical procedure. (4) Conclusion: Wearable sensors can be used during surgical procedure to assess fatigue. Periods of low-to-high activity and fatigue can be evaluated and visualized during surgery. Micro-breaks throughout surgical procedures are suggested to avoid fatigue and to prevent the risk of developing MSD.
摘要：
（1）背景：外科医生暴露于与工业工人相当的肌肉骨骼负荷。这些压力对关节和肌肉有害，并可能导致肌肉骨骼疾病（MSD）和外科医生无法工作。在本文中,我们提出了一种新颖的人体工程学和可视化方法来评估手术过程中的肌肉疲劳。（2）方法：外科医生对患者进行关节镜肩袖手术时，使用位置和肌电图可穿戴传感器评估肩带和颈/腰椎的八块肌肉的活动。均方根振幅和平均功率频率的时域和频域变量，分别,是从肌电图信号计算的。（3）结果：整个手术过程持续73分钟，分为与特定肌肉活动和疲劳水平相关的10个子阶段。大部分肌肉活动超过60%,而中斜方肌在整个手术过程中几乎不断激活（>20％）。（4）结论：可穿戴传感器可用于手术过程中评估疲劳。在手术过程中可以评估和观察低到高活动和疲劳的时期。建议在整个外科手术中进行微中断，以避免疲劳并防止发生MSD的风险。
