The following is a summary of “A Comparative Analysis of Ergonomic Risk Utilizing the 4K-3D Exoscope Versus Standard Operating Microscope for Male Fertility Microsurgery,” published in the FEBRUARY 2023 issue of Urology by Reddy, et al.

For a study, researchers sought to compare the ergonomic risk of using the 4K-3D exoscope versus the operating microscope (OM) for a urologic microsurgeon by stratifying their ergonomic risk using wearable technology.

A urologic microsurgeon was fitted with wearable inertial measurement units (IMUs) on the head and upper arms to measure joint angle change during microscopic procedures for male fertility. The modified rapid upper limb assessment was used to determine the proportion of time spent in each risk category. Categories 1-4 were assigned for the head and upper extremities (4= highest ergonomic risk). Chi-squared analysis was used to analyze differences in proportions.

Data from 500 and 479 minutes of 4K-3D exoscope and OM-guided surgeries, respectively, were analyzed. The 4K-3D exoscope was favorable regarding upper arm category 1 positioning compared to the OM (56.2% vs. 37.7%; P < .0001). The OM exposed the surgeon to a higher percentage of category 3 positioning (14.6% vs. 1.6%; P <.0001). More time was spent with the neck “extended” using the 4K-3D exoscope (51.8% vs. 19.5%; P < .0001) with 67% of neck extension between 0-10° (category 1). Overall, the OM favored longer operative times in low-risk neck ergonomic positions, and more time was spent with the neck in risk group 1-2 (P < .0001).

The 4K-3D exoscope offers favorable ergonomic positioning for the upper extremities, which may reduce work stress-related injury. However, more operative time was spent with the neck in mild extension with 4K-3D exoscope utilization, whereas the OM favored longer operative times in low-risk neck ergonomic positions.