ErgoPART: A Computerized Observational Tool to Quantify Postural Loading in Real-Time During Surgery

Figures & data

FIGURE 1 Primary (in the middle) and assisting vaginal surgeons (sides) performing a vaginal surgery.

TABLE 1 Body posture categories used in ErgoPART.

Assessed Postures	Definition	Neutral Postures	Non-neutral Postures
Neck Deviation	Angle of Frankfurt plane to the sagittal, transverse and coronal planes	<30°	≥30°
Trunk Flexion	Angle of the plane created by the shoulders (acromion process) and hips (anterior superior iliac spine) relative to the mid-coronal plane measured in the sagittal plane	<20°	≥20°
Trunk Lateral Bending	Angle of the plane created by the shoulders and hips relative to the mid-sagittal plane measured in in the coronal plane	<20°	≥20°
Shoulder Deviation	Angle of shoulder (acromion process) to elbow (lateral epidcondyle relative to the sagittal or coronal planes that pass through the acromion process	<60°	≥60°

TABLE 2 Tasks assigned to each pair of observers.

Observer Pairs	Tasks	Task Time (min)
Observer 1 and Observer 2	TVH	54.8
Observer 1 and Observer 3	BS	3.1
Observer 1 and Observer 4	USLS1	29.8
Observer 2 and Observer 3	Cysto	13.2
Observer 2 and Observer 4	USLS2	7.6
Observer 3 and Observer 4	USLS3	19.6

FIGURE 2 Schematic illustrating the calculation of % time identical and % absolute duration difference.

FIGURE 3 Data collection interface for the beta version of ErgoPART. Included are fields for subject number, data collection date and time, and the characterization of seven types of body postures.

FIGURE 4 ErgoPART's data collection interface contains fields that record: (a) basic information; (b) task information; (c) surgeon's positioning; (d) OR setting features; and (e) posture tracking.

FIGURE 5 The different combinations of posture codes that are illustrated in ErgoPART's Posture Tracking Field.

FIGURE 6 Example ErgoPART output listing the surgical tasks observed during the surgery in order of occurrence.

FIGURE 7 Example ErgoPART output summarizing the frequency and rate of non-neutral postures (number per minute) by body area for one surgeon during one surgery. The low rate of posture change with time is expected, given that surgical tasks often require surgeons to hold static neck, shoulder, and trunk postures for long time periods.

FIGURE 8 Example ErgoPART output listing the observed non-neutral neck postures in order of occurrence during one surgical task. In this 307 seconds of sample output, non-neutral neck postures were observed six times for a total duration of 152 seconds for the task of TVH. A step stool and sitting stool was not used, and the positions of the bed, patient, and surgeon remained fixed.

TABLE 3 Assessment of inter-observer agreement for each posture.

Non-Neutral Postures	% Observed Time Identical	% Observed Absolute Duration Difference	Difference in Posture Changes/Minute
Neck Deviation ≥30°	90.3	2.2	0.2
Right Shoulder Deviation >60°	84.2	1.3	0.1
Left Shoulder Deviation >60°	82.0	5.9	0.1
Trunk Flexion ≥20°	85.9	0.2	0.03
Trunk Lateral Bending >20°	85.9	1.5	0.1