{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:15:44Z","timestamp":1789773344342,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgeons experience one of the highest rates of work\u2010related musculoskeletal disorders, with otologists identified as a high\u2010risk specialty. This is commonly attributed to the frequent use of the operating microscope, as it often necessitates prolonged, ergonomically unfavourable, awkward postures. Robotic 3D\u2010exoscopes have emerged as a potential tool in improving surgical ergonomics without compromising on visualisation. This study compares the ergonomic risk associated with both devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, single centre, ergonomic analysis was conducted on otolaryngologists performing major otologic surgery using the OPMI Sensera operating microscope (Zeiss) and RoboticScope 3D\u2010exoscope (BHS Technologies). Ergonomic risk was evaluated using the Rapid Upper Limb Assessment (RULA) tool and a questionnaire based on the NASA Task Load Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen cases were performed; nine using the 3D\u2010exoscope and nine using the operating microscope. Use of the 3D exoscope significantly reduced ergonomic risk, with a lower mean RULA score (4.0) compared to the microscope (5.9). Subjectively, surgeons reported reduced physical strain, effort and weakness when using the 3D\u2010exoscope compared with the microscope, with similar cognitive and mental workload. Image quality, magnification, colour contrast, ease of use and usability of the 3D\u2010exoscope were rated positively. Further, the 3D\u2010exoscope was also rated highly for its educational value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>3D\u2010exoscopes appear to be more ergonomically favourable and suitable when compared to the operating microscope for major otologic surgery. Continued development and larger scale studies are warranted to improve ergonomics in otologic surgery and can also inform ergonomic improvements across other surgical specialties.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70278","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T10:53:53Z","timestamp":1754304833000},"page":"1862-1868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ergonomics of\n                    <scp>3D<\/scp>\n                    \u2010Exoscope Versus the Operating Microscope in Otologic Surgery"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-8739","authenticated-orcid":false,"given":"Ankit","family":"Ajmera","sequence":"first","affiliation":[{"name":"ENT Department Sydney Adventist Hospital  Sydney Australia"},{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raewyn G.","family":"Campbell","sequence":"additional","affiliation":[{"name":"ENT Department Sydney Adventist Hospital  Sydney Australia"},{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney Australia"},{"name":"Institute of Academic Surgery Royal Prince Alfred Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer W. 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