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Differential analysis of muscle fatigue induced elbow and wrist tremor in controlled laparoscopic manoeuvring
Asokan Thondiyath
Published in John Wiley and Sons Ltd
2017
PMID: 27647797
Volume: 13
   
Issue: 3
Abstract
Background: Fatigue induced hand tremor (FIT) is a primary limiting concern for the prolonged surgical intervention in minimally invasive surgery (MIS) and robot-assisted-minimally invasive surgery (RAMIS). A thorough analysis is necessary to understand the FIT characteristics in laparoscopic tool movement. The primary aim of this study is to perform a differential analysis of the elbow and wrist tremor due to muscle fatigue in laparoscopic manoeuvring. Methods: We have introduced a joint angle based tremor analysis method, which enables us to perform a differential study of FIT characteristics at the individual joint. Experimental data was acquired from a group of subjects during static and dynamic laparoscopic movement in an imitative RAMIS master manipulation scenario. A repetitive task was performed with a total span of 1 h for observing the effect of muscle fatigue. Along with the joint angle variation, surface electromyography (sEMG) signal was also studied in the analysis. Results: The wrist tremor is more predominant than tremor generated at the elbow, especially in highly fatigued condition. The high-frequency tremor (>4 Hz) is contributed by the wrist joint. Moreover, the variation of the wrist and elbow tremor ratio was found to be dependent upon the experience of the surgeons. Conclusions: In this work, we have investigated the attribution of elbow and wrist joints in FIT during laparoscopic tool manipulation. The outcomes may be useful for the design of robot-assisted surgical manipulator, and can be used for quality assessment of surgical training as well. Copyright © 2016 John Wiley & Sons, Ltd.
About the journal
JournalData powered by TypesetInternational Journal of Medical Robotics and Computer Assisted Surgery
PublisherData powered by TypesetJohn Wiley and Sons Ltd
ISSN14785951
Open AccessNo
Concepts (39)
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    Accelerometer
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    Adult
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    ARM MOVEMENT
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    Article
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    ELBOW TREMOR
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    Electromyography
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    Experience
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    Hand tremor
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    Human
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    Human experiment
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    LAPAROSCOPIC FORCEPS
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    LAPAROSCOPIC SURGERY
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    Mathematical analysis
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    Minimally invasive surgery
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    MUSCLE FATIGUE
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    Normal human
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    ROBOT ASSISTED SURGERY
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    Signal transduction
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    SURGEON
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    TASK PERFORMANCE
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    Tremor
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    WRIST TREMOR
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    Accelerometry
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    Biomechanics
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    ELBOW
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    Laparoscopy
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    MUSCLE FATIGUE
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    Pathophysiology
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    Physiology
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    ROBOTIC SURGICAL PROCEDURE
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    Wrist
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    Biomechanical phenomena
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    ELBOW JOINT
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    Humans
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    Minimally invasive surgical procedures
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    MUSCLE FATIGUE
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    ROBOTIC SURGICAL PROCEDURES
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    Task performance and analysis
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    WRIST JOINT