Abstract：
To assess neurosurgeons\' physical demands and investigate ergonomic aspects when using microsurgical visualization devices. Six neurosurgeons performed micro-surgical procedures on cadaveric specimens using the prototype of a digital 3D exoscope system (Aeos®, Aesculap, Tuttlingen, Germany) and a standard operating microscope (Pentero 900, Zeiss, Oberkochen, Germany) at two different patient positions (semisitting (SS), supine (SP)). The activities of the bilateral upper trapezius (UTM), anterior deltoid (ADM), and lumbar erector spinae (LEM) muscles were recorded using bipolar surface electromyography and neck flexion, arm abduction, and arm anteversion angles by gravimetrical posture sensors. Perceived discomfort frequency was assessed and subjects compared the two systems in terms of usability, posture, physical and mental demands, and working precision. Using the exoscope led to reduced ADM activity and increased UTM and LEM activity during SS position. The neck was extended when using the exoscope system with lower arm anteversion and abduction angles during the SS position. Subjects reported discomfort at the shoulder-neck area less frequently and lower physical demands when using the Aeos®. However, mental demands were slightly higher and two subjects reported lower working precision. The exoscope system has the potential to reduce the activity of the ADM by changing surgeons arm posture which may be accompanied by less discomfort in the shoulder-neck area. However, dependent on the applied patient position higher muscle activities could occur in the UTM and LEM.
摘要：
评估神经外科医生的身体需求并研究使用显微外科可视化设备时的人体工程学方面。六名神经外科医生使用数字3D出镜系统的原型（Aeos®，Aesculap,Tuttlingen,德国)和标准手术显微镜(Pentero900，蔡司，Oberkochen,德国)在两个不同的病人位置(半姿势(SS)，仰卧（SP））。双侧上斜方肌（UTM）的活动，前三角肌(ADM),使用双极表面肌电图和颈部屈曲记录腰竖脊肌（LEM）肌肉，手臂绑架,重力姿势传感器和手臂前倾角。评估了感知到的不适频率，并在可用性方面比较了两个系统，姿势,身体和精神的需求，和工作精度。在SS位置期间,使用外镜导致ADM活性降低和UTM和LEM活性增加。当在SS位置期间使用具有下臂前倾和外展角度的外镜系统时,颈部伸展。当使用Aeos®时,受试者较不频繁地报告肩颈区域的不适和较低的身体要求。然而,心理需求略高，两名受试者报告工作精度较低。出镜系统具有通过改变外科医生手臂姿势来减少ADM的活动的潜力，这可能伴随着肩颈区域的较少不适。然而,根据所应用的患者位置，UTM和LEM中可能会发生较高的肌肉活动。
