Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage
Introduction and hypothesis Surgeon kinematics play a significant role in the prevention of patient injury. We hypothesized that elbow extension and ulnar wrist deviation are associated with bladder injury during simulated midurethral sling (MUS) procedures. Methods We used motion capture technology...
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| Veröffentlicht in: | International Urogynecology Journal 2024-05, Vol.35 (5), p.1027-1034 |
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| creator | Sutkin, Gary Arif, Md. A. Cheng, An-Lin King, Gregory W. Stylianou, Antonis P. |
| description | Introduction and hypothesis
Surgeon kinematics play a significant role in the prevention of patient injury. We hypothesized that elbow extension and ulnar wrist deviation are associated with bladder injury during simulated midurethral sling (MUS) procedures.
Methods
We used motion capture technology to measure surgeons’ flexion/extension, abduction/adduction, and internal/external rotation angular time series for shoulder, elbow, and wrist joints. Starting and ending angles, minimum and maximum angles, and range of motion (ROM) were extracted from each time series. We created anatomical multibody models and applied linear mixed modeling to compare kinematics between trials with versus without bladder penetration and attending versus resident surgeons. A total of 32 trials would provide 90% power to detect a difference.
Results
Out of 85 passes, 62 were posterior to the suprapubic bone and 20 penetrated the bladder. Trials with versus without bladder penetration were associated with more initial wrist dorsiflexion (−27.32 vs −9.03°,
p
= 0.01), less final elbow flexion (39.49 vs 60.81,
p
= 0.03), and greater ROM in both the wrist (27.48 vs 14.01,
p
= 0.02), and elbow (20.45 vs 12.87,
p
= 0.04). Wrist deviation and arm pronation were not associated with bladder penetration. Compared with attendings, residents had more ROM in elbow flexion (14.61 vs 8.35°,
p
|
| doi_str_mv | 10.1007/s00192-024-05772-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11150917</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3039236282</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-84981c1f03c7a26e962112617db73465bd4e1afe37122fd844ee7bb894160a1c3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EotvCH-CAInHhEpixvXZyQqhsC6ISCFqJm-U4kyXVJk7HCaX_niwp5ePAyZb8zOt39AjxBOEFAtiXCQBLmYPUOaytlfn1PbFCrVSuQKr7YgWlsrnSRh6Iw5QuAUDDGh6KA1UYLA2qlfjyeeItxT67GAbibPN9ZOra8SZ73_bU-bENKXszcdtvsw1z5Mz39XLLT5go-0Qjx2Gq2pCdcwyes48-Jb-lR-JB43eJHt-eR-LiZHN-_DY_-3D67vj1WR60NGNe6LLAgA2oYL00VBqJKA3aurJz83VVa0LfkLIoZVMXWhPZqipKjQY8BnUkXi25c4mO6kD9yH7nBm47zzcu-tb9_dK3X902fnOIuIYS7Zzw_DaB49VEaXRdmwLtdr6nOCWnQJVSGVnIGX32D3oZJ-7n_WbKaI3Smn2gXKjAMSWm5q4Ngtubc4s5N5tzP82563no6Z973I38UjUDagHSsNdB_Pvv_8T-ABrepHs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3064412767</pqid></control><display><type>article</type><title>Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage</title><source>SpringerLink Journals - AutoHoldings</source><creator>Sutkin, Gary ; Arif, Md. A. ; Cheng, An-Lin ; King, Gregory W. ; Stylianou, Antonis P.</creator><creatorcontrib>Sutkin, Gary ; Arif, Md. A. ; Cheng, An-Lin ; King, Gregory W. ; Stylianou, Antonis P.</creatorcontrib><description>Introduction and hypothesis
Surgeon kinematics play a significant role in the prevention of patient injury. We hypothesized that elbow extension and ulnar wrist deviation are associated with bladder injury during simulated midurethral sling (MUS) procedures.
Methods
We used motion capture technology to measure surgeons’ flexion/extension, abduction/adduction, and internal/external rotation angular time series for shoulder, elbow, and wrist joints. Starting and ending angles, minimum and maximum angles, and range of motion (ROM) were extracted from each time series. We created anatomical multibody models and applied linear mixed modeling to compare kinematics between trials with versus without bladder penetration and attending versus resident surgeons. A total of 32 trials would provide 90% power to detect a difference.
Results
Out of 85 passes, 62 were posterior to the suprapubic bone and 20 penetrated the bladder. Trials with versus without bladder penetration were associated with more initial wrist dorsiflexion (−27.32 vs −9.03°,
p
= 0.01), less final elbow flexion (39.49 vs 60.81,
p
= 0.03), and greater ROM in both the wrist (27.48 vs 14.01,
p
= 0.02), and elbow (20.45 vs 12.87,
p
= 0.04). Wrist deviation and arm pronation were not associated with bladder penetration. Compared with attendings, residents had more ROM in elbow flexion (14.61 vs 8.35°,
p
< 0.01), but less ROM in wrist dorsiflexion (13.31 vs 20.33,
p
= 0.02) and arm pronation (4.75 vs 38.46,
p
< 0.01).
Conclusions
Bladder penetration during MUS is associated with wrist dorsiflexion and elbow flexion but not internal wrist deviation and arm supination. Attending surgeons exerted control with the wrist and forearm, surgical trainees with the elbow. Our findings have direct implications for MUS teaching.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-024-05772-w</identifier><identifier>PMID: 38619613</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Bladder ; Elbow ; Gynecology ; Kinematics ; Medicine ; Medicine & Public Health ; Original Article ; Surgeons ; Time series ; Urology</subject><ispartof>International Urogynecology Journal, 2024-05, Vol.35 (5), p.1027-1034</ispartof><rights>The International Urogynecological Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The International Urogynecological Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-84981c1f03c7a26e962112617db73465bd4e1afe37122fd844ee7bb894160a1c3</cites><orcidid>0000-0002-6336-5109</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-024-05772-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-024-05772-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38619613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sutkin, Gary</creatorcontrib><creatorcontrib>Arif, Md. A.</creatorcontrib><creatorcontrib>Cheng, An-Lin</creatorcontrib><creatorcontrib>King, Gregory W.</creatorcontrib><creatorcontrib>Stylianou, Antonis P.</creatorcontrib><title>Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
Surgeon kinematics play a significant role in the prevention of patient injury. We hypothesized that elbow extension and ulnar wrist deviation are associated with bladder injury during simulated midurethral sling (MUS) procedures.
Methods
We used motion capture technology to measure surgeons’ flexion/extension, abduction/adduction, and internal/external rotation angular time series for shoulder, elbow, and wrist joints. Starting and ending angles, minimum and maximum angles, and range of motion (ROM) were extracted from each time series. We created anatomical multibody models and applied linear mixed modeling to compare kinematics between trials with versus without bladder penetration and attending versus resident surgeons. A total of 32 trials would provide 90% power to detect a difference.
Results
Out of 85 passes, 62 were posterior to the suprapubic bone and 20 penetrated the bladder. Trials with versus without bladder penetration were associated with more initial wrist dorsiflexion (−27.32 vs −9.03°,
p
= 0.01), less final elbow flexion (39.49 vs 60.81,
p
= 0.03), and greater ROM in both the wrist (27.48 vs 14.01,
p
= 0.02), and elbow (20.45 vs 12.87,
p
= 0.04). Wrist deviation and arm pronation were not associated with bladder penetration. Compared with attendings, residents had more ROM in elbow flexion (14.61 vs 8.35°,
p
< 0.01), but less ROM in wrist dorsiflexion (13.31 vs 20.33,
p
= 0.02) and arm pronation (4.75 vs 38.46,
p
< 0.01).
Conclusions
Bladder penetration during MUS is associated with wrist dorsiflexion and elbow flexion but not internal wrist deviation and arm supination. Attending surgeons exerted control with the wrist and forearm, surgical trainees with the elbow. Our findings have direct implications for MUS teaching.</description><subject>Bladder</subject><subject>Elbow</subject><subject>Gynecology</subject><subject>Kinematics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgeons</subject><subject>Time series</subject><subject>Urology</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhi0EotvCH-CAInHhEpixvXZyQqhsC6ISCFqJm-U4kyXVJk7HCaX_niwp5ePAyZb8zOt39AjxBOEFAtiXCQBLmYPUOaytlfn1PbFCrVSuQKr7YgWlsrnSRh6Iw5QuAUDDGh6KA1UYLA2qlfjyeeItxT67GAbibPN9ZOra8SZ73_bU-bENKXszcdtvsw1z5Mz39XLLT5go-0Qjx2Gq2pCdcwyes48-Jb-lR-JB43eJHt-eR-LiZHN-_DY_-3D67vj1WR60NGNe6LLAgA2oYL00VBqJKA3aurJz83VVa0LfkLIoZVMXWhPZqipKjQY8BnUkXi25c4mO6kD9yH7nBm47zzcu-tb9_dK3X902fnOIuIYS7Zzw_DaB49VEaXRdmwLtdr6nOCWnQJVSGVnIGX32D3oZJ-7n_WbKaI3Smn2gXKjAMSWm5q4Ngtubc4s5N5tzP82563no6Z973I38UjUDagHSsNdB_Pvv_8T-ABrepHs</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Sutkin, Gary</creator><creator>Arif, Md. A.</creator><creator>Cheng, An-Lin</creator><creator>King, Gregory W.</creator><creator>Stylianou, Antonis P.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6336-5109</orcidid></search><sort><creationdate>20240501</creationdate><title>Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage</title><author>Sutkin, Gary ; Arif, Md. A. ; Cheng, An-Lin ; King, Gregory W. ; Stylianou, Antonis P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-84981c1f03c7a26e962112617db73465bd4e1afe37122fd844ee7bb894160a1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bladder</topic><topic>Elbow</topic><topic>Gynecology</topic><topic>Kinematics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgeons</topic><topic>Time series</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sutkin, Gary</creatorcontrib><creatorcontrib>Arif, Md. A.</creatorcontrib><creatorcontrib>Cheng, An-Lin</creatorcontrib><creatorcontrib>King, Gregory W.</creatorcontrib><creatorcontrib>Stylianou, Antonis P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sutkin, Gary</au><au>Arif, Md. A.</au><au>Cheng, An-Lin</au><au>King, Gregory W.</au><au>Stylianou, Antonis P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>35</volume><issue>5</issue><spage>1027</spage><epage>1034</epage><pages>1027-1034</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
Surgeon kinematics play a significant role in the prevention of patient injury. We hypothesized that elbow extension and ulnar wrist deviation are associated with bladder injury during simulated midurethral sling (MUS) procedures.
Methods
We used motion capture technology to measure surgeons’ flexion/extension, abduction/adduction, and internal/external rotation angular time series for shoulder, elbow, and wrist joints. Starting and ending angles, minimum and maximum angles, and range of motion (ROM) were extracted from each time series. We created anatomical multibody models and applied linear mixed modeling to compare kinematics between trials with versus without bladder penetration and attending versus resident surgeons. A total of 32 trials would provide 90% power to detect a difference.
Results
Out of 85 passes, 62 were posterior to the suprapubic bone and 20 penetrated the bladder. Trials with versus without bladder penetration were associated with more initial wrist dorsiflexion (−27.32 vs −9.03°,
p
= 0.01), less final elbow flexion (39.49 vs 60.81,
p
= 0.03), and greater ROM in both the wrist (27.48 vs 14.01,
p
= 0.02), and elbow (20.45 vs 12.87,
p
= 0.04). Wrist deviation and arm pronation were not associated with bladder penetration. Compared with attendings, residents had more ROM in elbow flexion (14.61 vs 8.35°,
p
< 0.01), but less ROM in wrist dorsiflexion (13.31 vs 20.33,
p
= 0.02) and arm pronation (4.75 vs 38.46,
p
< 0.01).
Conclusions
Bladder penetration during MUS is associated with wrist dorsiflexion and elbow flexion but not internal wrist deviation and arm supination. Attending surgeons exerted control with the wrist and forearm, surgical trainees with the elbow. Our findings have direct implications for MUS teaching.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38619613</pmid><doi>10.1007/s00192-024-05772-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6336-5109</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bladder Elbow Gynecology Kinematics Medicine Medicine & Public Health Original Article Surgeons Time series Urology |
| title | Surgeon Upper Extremity Kinematics During Error and Error-Free Retropubic Trocar Passage |
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