Impact of Microscope, Loupes, and Video Displays on Microsurgeons’ risk for Musculoskeletal Injuries

Microsurgery is commonly performed with operating microscopes or loupes to repair traumatic injuries, damage from cancer surgery, etc.; however, the prolonged, awkward, and constrained postures from using these equipment puts microsurgeons at risk for musculoskeletal pain and injuries. An alternative heads-up displays may improve surgeons’ ergonomics by allowing microsurgeons to perform the procedure in a more comfortable and ergonomic position. The study compares the effect of microscope, loupes and video displays on postures during microsurgical targeting task. This study incorporated three steps to contrast displays. Firstly, 12 participants wearing six reflective markers completed a surgery simulation using all three displays, and their sagittal planes were video recorded. Secondly, randomly selected frames were captured and coordinates calculated in Matlab. Lastly, angles of interests obtained were compared to suggest the optimal display that demand least stressful postures. The final results indicated that video displays would bring microsurgeons relatively comfort and freedom of postures. Future improvement on ergonomics in microsurgeons can be implemented through design of equipment, tasks and work environments

Design, fabrication, and testing of silicon microgimbals for super-compact rigid disk drives

This paper documents results related to design optimization, fabrication process refinement, and micron-level static/dynamic testing of silicon micromachined microgimbals that have applications in super-compact computer disk drives as well as many other engineering applications of microstructures and microactuators requiring significant out-of-plane motions. The objective of the optimization effort is to increase the in-plane to out-of-plane stiffness ratio in order to maximize compliance and servo bandwidth and to increase the displacement to strain ratio to maximize the shock resistance of the microgimbals, while that of the process modification effort is to simplify in order to reduce manufacturing cost. The testing effort is to characterize both the static and dynamic performance using precision instrumentation in order to compare various prototype designs

Silicon micromachined SCALED technology

Silicon micromachining technology will play an important role in the fabrication of high-bandwidth servo controlled microelectromechanical (mechatronic) components for super-compact disk drives. At the University of California, Los Angeles, and the California Institute of Technology, for the last three years, we have initiated a number of industry-supported joint research projects to develop the necessary technology building blocks for an integrated drive design of the future. These efforts include a silicon read/write head microgimbal with integrated electrical and mechanical interconnects, which targets the next-generation 30% form factor pico-sliders, and an electromagnetic piggyback microactuator in super-high-track-density applications, both of which utilize state-of-the-art silicon micromachining fabrication techniques

Silicon microstructures and microactuators for compact computer disk drives

Advances in VLSI and software technology have been the primary engines for the ongoing information revolution. But the steady stream of technical innovations in magnetic disk recording technology are also important factors contributing to the economic strengths of the computer and information industry. One important technology trend for the disk drive industry has been that of miniaturization. As this trend continues, future disk drives will have the same form factor as VLSIs, storing gigabytes of data. Silicon micromachining technology will play an important role in the fabrication of high-bandwidth servo-controlled microelectromechanical components for future super-compact disk drives. At UCLA and Caltech, for the past two years (1992-94) we have initiated a number of industry-supported joint research projects to develop microstructures and microactuators for future generation super compact magnetic recording rigid disk drives, including one to design and fabricate silicon read/write head microsuspensions with integrated electrical and mechanical interconnects, which target the next generation 30% form factor pico-sliders, and one for electromagnetic piggyback microactuators in super high-track-density applications, both of which utilize state-of-the-art silicon micromachining fabrication techniques

Application of Human Factors in Surgery: Studies on Technique, Displays, and Performance.

The overall goal of this work is to develop a framework that can be used to describe surgical procedures, measure performance, and identify ergonomic risk factors that may affect surgical outcomes and musculoskeletal stresses. Variations in technique commonly exist in surgical procedures; however, clinical evidence to support one technique over another is limited. Identifying best methods in surgical techniques and visualization equipment can reduce the risk factors for musculoskeletal fatigue among surgeons while improving surgical outcomes. This work presents a taxonomy that systematically quantifies differences in techniques among surgeons and cases. Using observed variations among surgeons, hypotheses were formulated on the relationship between different methods and outcomes that can be tested in future studies. The taxonomy was also used to formulate hypotheses on ergonomics factors that may impact surgeon’s musculoskeletal stresses and performance. Hypotheses on the effect of alternative video displays on postures and performance were tested in the laboratory setting. Results found that neck angles were significantly more erect on video displays than microscopes during simulated microsurgery skill tasks. In addition, more neck and shoulder movements were observed on the video displays than microscopes. Performance times on video displays were slower than microscopes and loupes. However, differences in performance times were smaller on the x (left/right) and y (fore/aft)-axes than the vertical z-axis. In addition, video displays were not significantly worse than other displays in overshoot and distance moved metrics that may be indicative of mechanical stress blood vessels may be exposed to in microsurgery. Contribution of this work includes: 1) development of a taxonomy for identifying best methods among variations in surgeon techniques that can be used for evidence-based training and assessment, 2) determining the impact of visualization equipment on surgeon’s risk for musculoskeletal symptoms and fatigue, and 3) measuring the impact of video displays on simulated microsurgery task performance and the limitations of such displays in surgery. Application of this work can be used to improve outcomes for both patients and medical practitioners during surgical procedures.PhDIndustrial and Operations EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/110344/1/dennyyu_1.pd

Leveraging Smart Infusion Pump Data for Workflow, Patient Care and Usability Improvement in Human Factors

Infusion pumps are medical devices that deliver fluids like medication, and nutrients in a precise, timely, and controlled manner that is critical to patient care. It is widely used in clinical settings especially in hospitals, nursing homes and sometimes at home. Smart infusion pumps technology are supposed to be reduce nurses’ workload, but due to the recurring number of alarms which disrupt the workflow of the infusion process, most nurses prefer to use the traditional infusion pumps or work-around the safety features of the smart pumps. Thus, the aim of this research is to leverage Smart Infusion Pump data to improve patient care, provider workflow, and usability. The data for this research is provided by the Regenstrief Center of Healthcare Engineering and a big data management hub, CatalyzeCare.org where a collaborative community of 123 health institutions contributed infusion pump data. By analyzing the data, the frequency and causes of the recurring alarms and also a detailed event of the workflow during the infusion process can be determined. However, one uncertainty about the data is the proper definition of one infusion process and ways to minimize the recurrences of the alarms. Hence, further analysis is being carried out to further investigate the problem and also to improve the usability of the Smart Infusion Pumps in the healthcare industry