{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:40:32Z","timestamp":1783690832299,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002551","name":"Seoul National University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002551","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to evaluate surgeons\u2019 ergonomic satisfaction when using laparoscopic energy devices and to investigate how prolonged use affects muscle fatigue and surgical performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A two-part study, including a survey and a kinesiologic experiment, was conducted to compare 4 laparoscopic energy devices (D1\u2013D4). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating muscle fatigue.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12082-9","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T15:52:35Z","timestamp":1757433155000},"page":"7576-7585","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the ergonomic aspects of laparoscopic energy devices: combination of a survey and a kinesiologic experiment"],"prefix":"10.1007","volume":"39","author":[{"given":"Hee Ju","family":"Sohn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junkyung","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoo Shin","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youngmin","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wooil","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaebum","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-0503","authenticated-orcid":false,"given":"Jin-Young","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"12082_CR1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2020.00076","author":"A St John","year":"2020","unstructured":"St John A, Caturegli I, Kubicki NS, Kavic SM (2020) The rise of minimally invasive surgery: 16 year analysis of the progressive replacement of open surgery with laparoscopy. JSLS. https:\/\/doi.org\/10.4293\/JSLS.2020.00076","journal-title":"JSLS"},{"key":"12082_CR2","doi-asserted-by":"publisher","first-page":"e1814","DOI":"10.1002\/rcs.1814","volume":"13","author":"H Kim","year":"2017","unstructured":"Kim H, Kim JR, Han Y, Kwon W, Kim SW, Jang JY (2017) Early experience of laparoscopic and robotic hybrid pancreaticoduodenectomy. Int J Med Robot Comput Assist Surg MRCAS 13:e1814","journal-title":"Int J Med Robot Comput Assist Surg MRCAS"},{"key":"12082_CR3","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.jamcollsurg.2009.10.017","volume":"210","author":"A Park","year":"2010","unstructured":"Park A, Lee G, Seagull FJ, Meenaghan N, Dexter D (2010) Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg 210:306\u2013313","journal-title":"J Am Coll Surg"},{"key":"12082_CR4","first-page":"105","volume-title":"Ergonomics in laparoscopic surgery","author":"FM S\u00e1nchez-Margallo","year":"2017","unstructured":"S\u00e1nchez-Margallo FM, S\u00e1nchez-Margallo JA (2017) Ergonomics in laparoscopic surgery. InTech, London, pp 105\u2013123"},{"key":"12082_CR5","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.jamcollsurg.2015.02.024","volume":"221","author":"Z Tsafrir","year":"2015","unstructured":"Tsafrir Z, Korianski J, Almog B, Many A, Wiesel O, Levin I (2015) Effects of fatigue on residents\u2019 performance in laparoscopy. J Am Coll Surg 221:564-570.e563","journal-title":"J Am Coll Surg"},{"key":"12082_CR6","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1097\/SLE.0000000000000231","volume":"26","author":"JM Shepherd","year":"2016","unstructured":"Shepherd JM, Harilingam MR, Hamade A (2016) Ergonomics in laparoscopic surgery\u2013a survey of symptoms and contributing factors. Surg Laparosc Endosc Percutan Tech 26:72\u201377","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"12082_CR7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/SLE.0b013e3181cded54","volume":"20","author":"MW Stomberg","year":"2010","unstructured":"Stomberg MW, Tronstad SE, Hedberg K, Bengtsson J, Jonsson P, Johansen L, Lindvall B (2010) Work-related musculoskeletal disorders when performing laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 20:49\u201353","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"12082_CR8","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1007\/s00464-003-8824-3","volume":"18","author":"R Berguer","year":"2004","unstructured":"Berguer R, Hreljac A (2004) The relationship between hand size and difficulty using surgical instruments: a survey of 726 laparoscopic surgeons. Surg Endosc 18:508\u2013512","journal-title":"Surg Endosc"},{"key":"12082_CR9","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1016\/j.jmig.2022.04.019","volume":"29","author":"JMK Wong","year":"2022","unstructured":"Wong JMK, Moore KJ, Carey ET (2022) Investigation of the association between surgeon sex and laparoscopic device ergonomic strain in gynecologic surgery. J Minim Invasive Gynecol 29:984\u2013991","journal-title":"J Minim Invasive Gynecol"},{"key":"12082_CR10","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/13645706.2023.2261533","volume":"33","author":"E Kono","year":"2024","unstructured":"Kono E, Nomura S, Sakamoto T, Okoshi K, Tanaka C, Shirabe K, Lee SW, Kitagawa Y (2024) Gender equity in surgical instruments: ergonomics of ring-handled forceps. Minim Invasive Ther Allied Technol 33:21\u201328","journal-title":"Minim Invasive Ther Allied Technol"},{"key":"12082_CR11","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1007\/s00464-013-2866-y","volume":"27","author":"CS Lim","year":"2013","unstructured":"Lim CS, Jang JY, Lee SE, Lee YJ, Kang MJ, Kim SW (2013) Comparison of various methods of vessel ligation: what is the safest method? Surg Endosc 27:3129\u20133138","journal-title":"Surg Endosc"},{"key":"12082_CR12","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jmig.2013.12.001","volume":"21","author":"A Fagotti","year":"2014","unstructured":"Fagotti A, Vizzielli G, Fanfani F, Gallotta V, Rossitto C, Costantini B, Gueli-Alletti S, Avenia N, Iodice R, Scambia G (2014) Randomized study comparing use of THUNDERBEAT technology vs standard electrosurgery during laparoscopic radical hysterectomy and pelvic lymphadenectomy for gynecologic cancer. J Minim Invasive Gynecol 21:447\u2013453","journal-title":"J Minim Invasive Gynecol"},{"key":"12082_CR13","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","volume":"126","author":"P Schober","year":"2018","unstructured":"Schober P, Boer C, Schwarte LA (2018) Correlation coefficients: appropriate use and interpretation. Anesth Analg 126:1763\u20131768","journal-title":"Anesth Analg"},{"key":"12082_CR14","doi-asserted-by":"publisher","first-page":"2310","DOI":"10.1007\/s00464-008-9986-9","volume":"22","author":"DM Adams","year":"2008","unstructured":"Adams DM, Fenton SJ, Schirmer BD, Mahvi DM, Horvath K, Nichol P (2008) One size does not fit all: current disposable laparoscopic devices do not fit the needs of female laparoscopic surgeons. Surg Endosc 22:2310\u20132313","journal-title":"Surg Endosc"},{"key":"12082_CR15","first-page":"6539","volume":"2014","author":"S Chandra","year":"2014","unstructured":"Chandra S, Hayashibe M, Thondiyath A (2014) Dominant component in muscle fatigue induced hand tremor during laparoscopic surgical manipulation. Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Int Conf 2014:6539\u20136542","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Int Conf"},{"key":"12082_CR16","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1080\/13645706.2018.1470984","volume":"28","author":"K Platte","year":"2019","unstructured":"Platte K, Alleblas CCJ, Inthout J, Nieboer TE (2019) Measuring fatigue and stress in laparoscopic surgery: validity and reliability of the star-track test. Minim Invasive Ther Allied Technol 28:57\u201364","journal-title":"Minim Invasive Ther Allied Technol"},{"key":"12082_CR17","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1007\/s00464-009-0714-x","volume":"24","author":"D B\u00fcchel","year":"2010","unstructured":"B\u00fcchel D, M\u00e5rvik R, Hallabrin B, Matern U (2010) Ergonomics of disposable handles for minimally invasive surgery. Surg Endosc 24:992\u20131004","journal-title":"Surg Endosc"},{"key":"12082_CR18","doi-asserted-by":"publisher","first-page":"3480","DOI":"10.1007\/s00464-015-4634-7","volume":"30","author":"D Yu","year":"2016","unstructured":"Yu D, Lowndes B, Morrow M, Kaufman K, Bingener J, Hallbeck S (2016) Impact of novel shift handle laparoscopic tool on wrist ergonomics and task performance. Surg Endosc 30:3480\u20133490","journal-title":"Surg Endosc"},{"key":"12082_CR19","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1007\/s00464-018-6478-4","volume":"33","author":"JG Z\u00e1rate Rodriguez","year":"2019","unstructured":"Z\u00e1rate Rodriguez JG, Zihni AM, Ohu I, Cavallo JA, Ray S, Cho S, Awad MM (2019) Ergonomic analysis of laparoscopic and robotic surgical task performance at various experience levels. Surg Endosc 33:1938\u20131943","journal-title":"Surg Endosc"},{"key":"12082_CR20","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1007\/s00464-014-3497-7","volume":"28","author":"AM Zihni","year":"2014","unstructured":"Zihni AM, Ohu I, Cavallo JA, Ousley J, Cho S, Awad MM (2014) FLS tasks can be used as an ergonomic discriminator between laparoscopic and robotic surgery. Surg Endosc 28:2459\u20132465","journal-title":"Surg Endosc"},{"key":"12082_CR21","doi-asserted-by":"publisher","first-page":"3379","DOI":"10.1007\/s00464-014-3604-9","volume":"28","author":"AM Zihni","year":"2014","unstructured":"Zihni AM, Ohu I, Cavallo JA, Cho S, Awad MM (2014) Ergonomic analysis of robot-assisted and traditional laparoscopic procedures. Surg Endosc 28:3379\u20133384","journal-title":"Surg Endosc"},{"key":"12082_CR22","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1007\/s00464-018-6515-3","volume":"33","author":"PR Armijo","year":"2019","unstructured":"Armijo PR, Huang CK, High R, Leon M, Siu KC, Oleynikov D (2019) Ergonomics of minimally invasive surgery: an analysis of muscle effort and fatigue in the operating room between laparoscopic and robotic surgery. Surg Endosc 33:2323\u20132331","journal-title":"Surg Endosc"},{"key":"12082_CR23","doi-asserted-by":"publisher","first-page":"8397","DOI":"10.1007\/s00464-022-09105-0","volume":"36","author":"S Monfared","year":"2022","unstructured":"Monfared S, Athanasiadis DI, Umana L, Hernandez E, Asadi H, Colgate CL, Yu D, Stefanidis D (2022) A comparison of laparoscopic and robotic ergonomic risk. Surg Endosc 36:8397\u20138402","journal-title":"Surg Endosc"},{"key":"12082_CR24","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.jmig.2014.10.004","volume":"22","author":"ME Tarr","year":"2015","unstructured":"Tarr ME, Brancato SJ, Cunkelman JA, Polcari A, Nutter B, Kenton K (2015) Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study. J Minim Invasive Gynecol 22:234\u2013238","journal-title":"J Minim Invasive Gynecol"},{"key":"12082_CR25","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s00464-016-5076-6","volume":"31","author":"M Gonz\u00e1lez-S\u00e1nchez","year":"2017","unstructured":"Gonz\u00e1lez-S\u00e1nchez M, Gonz\u00e1lez-Poveda I, Mera-Velasco S, Cuesta-Vargas AI (2017) Comparison of fatigue accumulated during and after prolonged robotic and laparoscopic surgical methods: a cross-sectional study. Surg Endosc 31:1119\u20131135","journal-title":"Surg Endosc"},{"key":"12082_CR26","doi-asserted-by":"publisher","first-page":"6672","DOI":"10.1007\/s00464-021-08937-6","volume":"36","author":"T Thurston","year":"2022","unstructured":"Thurston T, Dolan JP, Husain F, Stroud A, Funk K, Borzy C, Zhu X (2022) Assessment of muscle activity and fatigue during laparoscopic surgery. Surg Endosc 36:6672\u20136678","journal-title":"Surg Endosc"},{"key":"12082_CR27","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jss.2016.03.058","volume":"203","author":"AM Zihni","year":"2016","unstructured":"Zihni AM, Cavallo JA, Ray S, Ohu I, Cho S, Awad MM (2016) Ergonomic analysis of primary and assistant surgical roles. J Surg Res 203:301\u2013305","journal-title":"J Surg Res"},{"key":"12082_CR28","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1016\/j.jmig.2022.09.552","volume":"29","author":"JMK Wong","year":"2022","unstructured":"Wong JMK, Moore KJ, Lewis P, Reid M, Saul K, Carey ET (2022) Ergonomic assessment of surgeon characteristics and laparoscopic device strain in gynecologic surgery. J Minim Invasive Gynecol 29:1357\u20131363","journal-title":"J Minim Invasive Gynecol"},{"key":"12082_CR29","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1111\/ases.13005","volume":"15","author":"S Ohtake","year":"2022","unstructured":"Ohtake S, Makiyama K, Yamashita D, Tatenuma T, Yao M (2022) Training on a virtual reality laparoscopic simulator improves performance of live laparoscopic surgery. Asian J Endosc Surg 15:313\u2013319","journal-title":"Asian J Endosc Surg"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12082-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-12082-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12082-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:36:26Z","timestamp":1763145386000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-12082-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["12082"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-12082-9","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"assertion":[{"value":"14 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JY Jang received an investigator-initiated research grant from Johnson and Johnson Medical Applies, and a grant from the Korean Association of Hepato-Biliary and Pancreas Surgery (KAHBPS-22\u201308). The funder was involved only in the selection and awarding of the research grant. Hee Ju Sohn, Junkyung Song, Yoo Shin Choi, Youngmin Han, Wooil Kwon and Jaebum Park have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The study protocol was approved by the Institutional Review Board of Seoul National University Hospital (SNUH- 2012\u2013165-1184). Written informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}