The following is a summary of “Ergonomics in the OR: An Electromyographic Evaluation of Common Muscle Groups Used During Simulated Flexible Ureteroscopy – a Pilot Study” published in the December 2022 issue of Urology by Wright et al.

Using a kidney phantom and an endourology box-trainer model, researchers, for a study, sought to simulate ureteroscopy to determine the effects of various surgeon postures and ureteroscope types on muscle activation as determined by surface electromyography (sEMG).

Three endourology fellows’ muscle activation during various ureteroscopic activities was measured for the exploratory investigation using sEMG. The muscles thenar, forearm flexor, forearm extensor, biceps, triceps, deltoid, and trapezius were all used to place electrodes on the side that held the ureteroscope. The subjects used a cystoscopy table with surgical drapes and an endoscopic video tower while wearing fitting lead aprons in the operating room. Tests were conducted in both the standing and sitting postures using a disposable and reusable ureteroscope. To simulate the procedural steps of basketing, navigating a renal collecting system, and dusting, each subject completed an identical set of activities in a phantom silicone kidney and ureteroscopy box trainer. To enable comparison, the raw EMG data for each task was processed and normalized as a percentage of the maximal voluntary contraction for each individual.

The muscle that was used the most frequently was the forearm extensor. Forearm flexors were more active while standing than sitting, but the trapezius and deltoid muscles were more active. In comparison to the disposable ureteroscope, the heavier reusable ureteroscope activated the forearm extensors more.

According to preliminary data, there were discernible variations in muscle activation depending on the surgical technique and ureteroscope type. It emphasized the need for additional in-depth EMG research to pinpoint methods and tools to improve ergonomics and reduce injuries during flexible ureteroscopy.