# Evaluating the ergonomic aspects of laparoscopic energy devices: combination of a survey and a kinesiologic experiment

## TL;DR

This study examined how laparoscopic energy devices affect surgeon comfort and performance, finding that some devices cause muscle fatigue and reduced accuracy during prolonged use.

## Contribution

The study combines ergonomic surveys with kinesiologic experiments to evaluate laparoscopic devices and their impact on muscle fatigue and surgical precision.

## Key findings

- Two devices showed significant decline in precision and targeting accuracy after fatigue.
- All but one device showed significant changes in EMG signals, indicating muscle fatigue.
- Ergonomic differences among devices were significant based on surgeon feedback.

## Abstract

This study aimed to evaluate surgeons’ ergonomic satisfaction when using laparoscopic energy devices and to investigate how prolonged use affects muscle fatigue and surgical performance.

A two-part study, including a survey and a kinesiologic experiment, was conducted to compare 4 laparoscopic energy devices (D1–D4). Thirty surgeons completed a structured survey assessing ergonomic factors such as device weight, grip strength, handle design, comfort, and trigger location. In parallel, a kinesiologic experiment involving 20 surgeons measured device activation force, surface electromyography (EMG) changes, and targeting accuracy before and after fatigue induction using a standardized protocol.

The survey revealed significant ergonomic differences among devices. In the kinesiologic study, two devices showed a significant decline in precision and targeting accuracy after fatigue. All but one device demonstrated significant changes in the median frequency (MDF) and integrated EMG (iEMG) of the flexor digitorum superficialis muscle (P < 0.001), indicating muscle fatigue.

Prolonged use of certain laparoscopic energy devices induces muscle fatigue and impairs accuracy. These findings underscore the importance of ergonomic considerations in surgical instrument design to enhance surgeon performance and reduce fatigue-related risks.

The online version contains supplementary material available at 10.1007/s00464-025-12082-9.