Muscle fatigue and performance analysis during fundamental laparoscopic surgery tasks

The goal of this study is to detect muscle fatigue and time-to-fatigue in vulnerable muscle groups, before determining whether the former has any effect on surgical performance. In the experiment, surface electromyography (sEMG) was deployed to record the muscle activations of 12 subjects while performing fundamentals of laparoscopic surgery (FLS) tasks for a total of three hours. In all, 16 muscle groups were tested. The resultant data were then reconstructed using recurrence quantification analysis (RQA). In addition, a subjective fatigue assessment was conducted to draw comparisons with the RQA results. The subjects' performance was also investigated via a FLS task performance analysis, the results demonstrating that RQA can detect muscle fatigue in 12 muscle groups as well as their time-to-fatigue. The results also indicated that RQA and subjective fatigue assessment are very closely correlated (p-value < 0.05). However, the performance analysis results showed that the subjects' performance improved over time.