Chairless Chairs for Orthopedic Surgery Purpose – A Literature Review

Gatot Santoso; S. Sugiharto; Abdul Mughni; Muhammad Imam Ammarullah; Athanasius P. Bayuseno; J. Jamari

doi:10.3889/oamjms.2022.8148

Authors

Gatot Santoso Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung, Indonesia; Department of Mechanical Engineering, Faculty of Engineering, Diponegoro University, Semarang, Indonesia https://orcid.org/0000-0003-2368-193X
S. Sugiharto Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung, Indonesia
Abdul Mughni Department of Surgery, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Muhammad Imam Ammarullah Department of Mechanical Engineering, Faculty of Engineering, Diponegoro University, Semarang, Indonesia; Undip Biomechanics Engineering and Research Centre (UBM-ERC), Diponegoro University, Semarang, Indonesia https://orcid.org/0000-0002-8845-7202
Athanasius P. Bayuseno Department of Mechanical Engineering, Faculty of Engineering, Diponegoro University, Semarang, Indonesia
J. Jamari Department of Mechanical Engineering, Faculty of Engineering, Diponegoro University, Semarang, Indonesia; Undip Biomechanics Engineering and Research Centre (UBM-ERC), Diponegoro University, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8148

Keywords:

Chairless chair, Orthopaedic surgery, Musculoskeletal disorders

Abstract

Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further explored to close the existing research gap.

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References

Nourollahi-Darabad M, Afshari D, Dianat I, Jodakinia L. Longduration assessment of upper arm posture and motion and their association with perceived symptoms among bakery workers. Int J Ind Ergon. 2020;80:103029. https://doi.org/10.1016/j.ergon.2020.103029 DOI: https://doi.org/10.1016/j.ergon.2020.103029

Ambarwati T, Suroto S, Wicaksana B, Sopianah Y, Miko H. Posture work to complaint musculoskeletal disorders at the dentist. J Int Dent Med Res. 2018;11(1):57-61.

Ammarullah MI, Afif IY, Maula MI, Winarni TI, Tauviqirrahman M, Jamari J. Tresca stress evaluation of Metal-on-UHMWPE total hip arthroplasty during peak loading from normal walking activity. Mater. Today Proc (article in press). https://doi.org/10.1016/j.matpr.2022.02.055 DOI: https://doi.org/10.1016/j.matpr.2022.02.055

Ammarullah MI, Afif IY, Maula MI, Winarni TI, Tauviqirrahman M, Bayuseno AP, et al. 2D computational tresca stress prediction of CoCrMo-on-UHMWPE bearing of total hip prosthesis based on body mass index. Malaysian J Med Health Sci. 2021;17 Suppl 13:18-21. Available from: https://www.medic.upm.edu.my/jurnal_kami/malaysian_journal_of_medicine_and_health_sciences_mjmhs/mjmhs_vol17_supp_13_december_2021-64714. [Last accessed on 2021 Sep 23].

Jaffar N, Abdul-Tharim AH, Mohd-Kamar IF, Lop NS. A literature review of ergonomics risk factors in construction industry. Procedia Eng. 2011;20:89-97. DOI: https://doi.org/10.1016/j.proeng.2011.11.142

Memon AG, Naeem Z, Zaman A, Zahid F. Occupational health related concerns among surgeons. Int J Health Sci (Qassim). 2016;10(2):279-91. PMid:27103909 DOI: https://doi.org/10.12816/0048819

Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, et al. Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: A systematic review and meta-analysis. JAMA Surg. 2018;153(2):e174947. https://doi.org/10.1001/jamasurg.2017.4947 PMid:29282463 DOI: https://doi.org/10.1001/jamasurg.2017.4947

Stomberg MW, Tronstad SE, Hedberg K, Bengtsson J, Jonsson P, Johansen L, et al. Work-related musculoskeletal disorders when performing laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2010;20(1):49-53. https://doi.org/10.1097/SLE.0b013e3181cded54 PMid:20173622 DOI: https://doi.org/10.1097/SLE.0b013e3181cded54

Lavé A, Gondar R, Demetriades AK, Meling TR. Ergonomics and musculoskeletal disorders in neurosurgery: A systematic review. Acta Neurochir (Wien). 2020;162(9):2213-20. https://doi.org/10.1007/s00701-020-04494-4 PMid:32705353 DOI: https://doi.org/10.1007/s00701-020-04494-4

Mündermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Orthotic comfort is related to kinematics, kinetics, and EMG in recreational runners. Med Sci Sports Exerc. 2003;35(10):1710-9. https://doi.org/10.1249/01.MSS.0000089352.47259.CA PMid:14523309 DOI: https://doi.org/10.1249/01.MSS.0000089352.47259.CA

Mahendra NY, Putra DP, Akbar I, Putra RU, Prakoso AT, Yanis M, et al. Narrative Review of Subchondral Bone Morphology on Cartilage Damage (Osteoarthritis). Proc. 5th FIRST T1 T2 2021 Int. Conf. (FIRST-T1-T2 2021). 2022;9:77–82. https://doi.org/10.2991/ahe.k.220205.014 DOI: https://doi.org/10.2991/ahe.k.220205.014

Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN. Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskelet Disord. 2014;15(1):4. https://doi.org/10.1186/1471-2474-15-4 PMid:24397703 DOI: https://doi.org/10.1186/1471-2474-15-4

Johanning E. Evaluation and management of occupational low back disorders. Am J Ind Med. 2000;37(1):94-111. https://doi.org/10.1002/(sici)1097-0274(200001)37:1<94:aid-ajim8>3.0.co;2-x PMid:10573599 DOI: https://doi.org/10.1002/(SICI)1097-0274(200001)37:1<94::AID-AJIM8>3.0.CO;2-X

Rosenblatt PL, McKinney J, Adams SR. Ergonomics in the operating room: Protecting the surgeon. J Minim Invasive Gynecol. 2013;20(6):744. https://doi.org/10.1016/j.jmig.2013.07.006 PMid:23969139 DOI: https://doi.org/10.1016/j.jmig.2013.07.006

Yasuhara T, Kuwahara K, Sasada S, Toyoshima A, Morimoto J, Kin K, et al. Surgery in the standing position by a surgeon with achilles tendon rupture. Acta Med Okayama. 2016;70(6):493-6. https://doi.org/10.18926/AMO/54813 PMid:28003675

Maula MI, Aji AL, Aliyafi MB, Afif IY, Ammarullah MI, Winarni TI, et al. The subjective comfort test of autism hug machine portable seat. J Intellect Disabil. 2021;9(2):182-8. https://doi.org/10.6000/2292-2598.2021.09.02.4 DOI: https://doi.org/10.6000/2292-2598.2021.09.02.4

Jafry T, O’Neill DH. The application of ergonomics in rural development: A review. Appl Ergon. 2000;31(3):263-8. https://doi.org/10.1016/s0003-6870(99)00051-4 PMid:10855449 DOI: https://doi.org/10.1016/S0003-6870(99)00051-4

Berguer R, Smith W. An ergonomic comparison of robotic and laparoscopic technique: The influence of surgeon experience and task complexity. J Surg Res. 2006;134(1):87-92. https://doi.org/10.1016/j.jss.2005.10.003 PMid:16376941 DOI: https://doi.org/10.1016/j.jss.2005.10.003

Sers R, Forrester S, Zecca M, Ward S, Moss E. The ergonomic impact of patient body mass index on surgeon posture during simulated laparoscopy. Appl Ergon. 2021;97:103501. https://doi.org/10.1016/j.apergo.2021.103501 PMid:34167015 DOI: https://doi.org/10.1016/j.apergo.2021.103501

Matern U. Principles of ergonomic instrument handles. Minim Invasive Ther Allied Technol. 2001;10(3):169-73. https://doi.org/10.1080/136457001753192295 PMid:16754010 DOI: https://doi.org/10.1080/136457001753192295

Ammarullah MI, Afif IY, Maula MI, Winarni TI, Tauviqirrahman M, Akbar I, et al. Tresca stress simulation of metal-on-metal total hip arthroplasty during normal walking Activity. Materials (Basel). 2021;14(24):7554. https://doi.org/10.3390/ma14247554 PMid:34947150 DOI: https://doi.org/10.3390/ma14247554

Afif IY, Farkhan M, Kurdi O, Maula MI, Ammarullah MI, Setiyana B, et al. Effect of short-term deep-pressure portable seat on behavioral and biological stress in children with autism spectrum disorders: A pilot study. Bioengineering. 2022;9(2):48. https://doi.org/10.3390/bioengineering9020048 PMid:35200402 DOI: https://doi.org/10.3390/bioengineering9020048

Ammarullah MI, Saad APM, Syahrom A, Basri H. Contact pressure analysis of acetabular cup surface with dimple addition on total hip arthroplasty using finite element method. IOP Conf Ser Mater Sci Eng. 2021;1034(1):1-11. https://doi.org/10.1088/1757-899X/1034/1/012001 DOI: https://doi.org/10.1088/1757-899X/1034/1/012001

Jamari J, Ammarullah MI, Saad APM, Syahrom A, Uddin M, Heide E van der, et al. The Effect of Bottom Profile Dimples on the Femoral Head on Wear in Metal-on-Metal Total Hip Arthroplasty. J Funct Biomater. 2021;12(2):38. https://doi.org/10.3390/jfb12020038 DOI: https://doi.org/10.3390/jfb12020038

Basri H, Syahrom A, Prakoso AT, Wicaksono D, Amarullah MI, Ramadhoni TS, et al. The Analysis of Dimple Geometry on Artificial Hip Joint to the Performance of Lubrication. J Phys Conf Ser. 2019;1198(4):1-10. https://doi.org/10.1088/1742-6596/1198/4/042012 DOI: https://doi.org/10.1088/1742-6596/1198/4/042012

Basri H, Syahrom A, Ramadhoni TS, Prakoso AT, Ammarullah MI, Vincent. The analysis of the dimple arrangement of the artificial hip joint to the performance of lubrication. IOP Conf Ser Mater Sci Eng. 2019;620(1):1-10. https://doi.org/10.1088/1757-899X/620/1/012116 DOI: https://doi.org/10.1088/1757-899X/620/1/012116

Schlussel AT, Maykel JA. Ergonomics and musculoskeletal health of the surgeon. Clin Colon Rectal Surg. 2019;32(6):424-34. https://doi.org/10.1055/s-0039-1693026 PMid:31686994 DOI: https://doi.org/10.1055/s-0039-1693026

Rupal BS, Rafique S, Singla A, Singla E, Isaksson M, Virk GS. Lower-limb exoskeletons: Research trends and regulatory guidelines in medical and non-medical applications. Int J Adv Robot Syst. 2017;14(6):1-27. https://doi.org/10.1177/1729881417743554 DOI: https://doi.org/10.1177/1729881417743554

Pawar MV, Ohol SS, Patil A. Modelling and development of compressed air powered human exoskeleton suit human exoskeleton. In: 2018 7th International Conference on Reliability, Infocom Technologies and Optimization Trends Futur Dir, ICRITO 2018; 2018. p. 861-6. DOI: https://doi.org/10.1109/ICRITO.2018.8748797

Jamari J, Ammarullah MI, Afif IY, Ismail R, Tauviqirrahman M, Bayuseno AP. Running-in analysis of transmission gear. Tribol Ind. 2021;43(3):434-41. https://doi.org/10.24874/ti.1092.04.21.08 DOI: https://doi.org/10.24874/ti.1092.04.21.08

Kang I, Hsu H, Young A. The effect of hip assistance levels on human energetic cost using robotic hip exoskeletons. IEEE Robot Autom Lett. 2019;4(2):430-7. DOI: https://doi.org/10.1109/LRA.2019.2890896

Kapsalyamov A, Jamwal PK, Hussain S, Ghayesh MH. State of the art lower limb robotic exoskeletons for elderly assistance. IEEE Access. 2019;7:95075-86. DOI: https://doi.org/10.1109/ACCESS.2019.2928010

Mudie KL, Boynton AC, Karakolis T, O’Donovan MP, Kanagaki GB, Crowell HP, et al. Consensus paper on testing and evaluation of military exoskeletons for the dismounted combatant. J Sci Med Sport. 2018;21(11):1154-61. https://doi.org/10.1016/j.jsams.2018.05.016 PMid:30318056 DOI: https://doi.org/10.1016/j.jsams.2018.05.016

Spada S, Ghibaudo L, Gilotta S, Gastaldi L, Cavatorta MP. Investigation into the applicability of a passive upperlimb exoskeleton in automotive industry. Procedia Manuf. 2017;11:1255-62. https://doi.org/10.1016/j.promfg.2017.07.252 DOI: https://doi.org/10.1016/j.promfg.2017.07.252

Kagirov I, Kapustin A, Kipyatkova I, Klyuzhev K, Kudryavcev A, Kudryavcev I, et al. Medical exoskeleton “Remotion” with an intelligent control system: Modeling, implementation, and testing. Simul Model Pract Theory. 2021;107:102200. https://doi.org/10.1016/j.simpat.2020.102200 DOI: https://doi.org/10.1016/j.simpat.2020.102200

Zhu Z, Dutta A, Dai F. Exoskeletons for manual material handling-a review and implication for construction applications. Autom Constr. 2021;122:103493. https://doi.org/10.1016/j.autcon.2020.103493 DOI: https://doi.org/10.1016/j.autcon.2020.103493

Liu S, Hemming D, Luo RB, Reynolds J, Delong JC, Sandler BJ, et al. Solving the surgeon ergonomic crisis with surgical exosuit. Surg Endosc. 2018;32(1):236-44. https://doi.org/10.1007/s00464-017-5667-x PMid:28643066 DOI: https://doi.org/10.1007/s00464-017-5667-x

Noone. Chairless Chair 2.0-Die Neue Generation, Noone; 2021. Available from: https://www.noonee.com [Last accessed on 2021 Sep 01].

Wang Z, Wu X, Zhang Y, Chen C, Liu S, Liu Y, et al. A semiactive exoskeleton based on emgs reduces muscle fatigue when squatting. Front Neurorobot. 2021;15:625479. https://doi.org/10.3389/fnbot.2021.625479 PMid:33889081 DOI: https://doi.org/10.3389/fnbot.2021.625479

Huysamen K, de Looze M, Bosch T, Ortiz J, Toxiri S, O’Sullivan LW. Assessment of an active industrial exoskeleton to aid dynamic lifting and lowering manual handling tasks. Appl Ergon. 2018;68:125-31. https://doi.org/10.1016/j.apergo.2017.11.004 PMid:29409626 DOI: https://doi.org/10.1016/j.apergo.2017.11.004

Elisheba DD, Britto Y, Christina VP. CHair-less chair for lumbar pain reduction. Int J Mech Eng Technol. 2018;9(11):500-7.

Luger T, Seibt R, Cobb TJ, Rieger MA, Steinhilber B. Influence of a passive lower-limb exoskeleton during simulated industrial work tasks on physical load, upper body posture, postural control and discomfort. Appl Ergon. 2019;80:152-60. https://doi.org/10.1016/j.apergo.2019.05.018 PMid:31280799 DOI: https://doi.org/10.1016/j.apergo.2019.05.018

Luger T, Cobb TJ, Seibt R, Rieger MA, Steinhilber B. Subjective evaluation of a passive lower-limb industrial exoskeleton used during simulated assembly. IISE Trans Occup Ergon Hum. Factors. 2019;7(3-4):175-84. DOI: https://doi.org/10.1080/24725838.2018.1560376

Pillai MV, van Engelhoven L, Kazerooni H. Evaluation of a lower leg support exoskeleton on floor and below hip height panel work. Hum Factors. 2020;62(3):489-500. https://doi.org/10.1177/0018720820907752 PMid:32150477 DOI: https://doi.org/10.1177/0018720820907752

Jeong M, Woo H, Kong K. A study on weight support and balance control method for assisting squat movement with a wearable robot, angel-suit. Int J Control Autom Syst. 2020;18(1):114-23. DOI: https://doi.org/10.1007/s12555-019-0243-x

Sado F, Yap HJ, Ghazilla RAR, Ahmad N. Design and control of a wearable lower-body exoskeleton for squatting and walking assistance in manual handling works. Mechatronics. 2019;63:102272. https://doi.org/10.1016/j.mechatronics.2019.102272 DOI: https://doi.org/10.1016/j.mechatronics.2019.102272

Bridger RS, Ashford AI, Wattie S, Dobson K, Fisher I, Pisula PJ. Sustained attention when squatting with and without an exoskeleton for the lower limbs. Int J Ind Ergon. 2018;66:230-9. https://doi.org/10.1016/j.ergon.2018.03.005 DOI: https://doi.org/10.1016/j.ergon.2018.03.005

Capitani SL, Bianchi M, Secciani N, Pagliai M, Meli E, Ridolfi A. Model-based mechanical design of a passive lowerlimb exoskeleton for assisting workers in shotcrete projection. Meccanica. 2021;56(1):195-210. https://doi.org/10.1007/s11012-020-01282-3 DOI: https://doi.org/10.1007/s11012-020-01282-3

Ippolito D, Constantinescu C, Riedel O. Holistic planning and optimization of human-centred workplaces with integrated Exoskeleton technology. Procedia CIRP. 2020;88:214-7. https://doi.org/10.1016/j.procir.2020.05.038 DOI: https://doi.org/10.1016/j.procir.2020.05.038

Irawan AP, Utama DW, Affandi E, Michael M, Suteja H. Product design of chairless chair based on local components to provide support for active workers. IOP Conf Ser Mater Sci Eng. 2019;508(1):1-6. DOI: https://doi.org/10.1088/1757-899X/508/1/012054

Kurnia AF. Rancang Bangun Chairless Chair. Indonesia: Pasundan University; 2018.

Mogare MR, Sravasti SS, Ashtekar RV, Sovani GC. Research paper on VIRTUAL CHAIR: An exoskeleton. Int Res J Eng Technol. 2017;4(5):2328-35.

Siddha B, Biradar V, Darwatkar V, Shubham D, Suresh W. Chairless chair. Int J Res Appl Sci Eng Technol. 2018;5(6):218-21.

Yan Z, Han B, Du Z, Huang T, Bai O, Peng A. Development and testing of a wearable passive lower-limb support exoskeleton to support industrial workers. Biocybern Biomed Eng. 2021;41(1):221-38. https://doi.org/10.1016/j.bbe.2020.12.010 DOI: https://doi.org/10.1016/j.bbe.2020.12.010

Magdum RM, Jadhav SM. Design and implementation of chair less seating arrangement for industrial workers and farmers. Glob Res Dev J Eng. 2018;3(8):5-11.

Houben BH. Satisfaction with the Physical Working Environment. Netherlands: Eindhoven University of Technology; 2015.

Choi J. Application of assistive wearable robotics to alleviate construction workforce shortage: Challenges and opportunities. In: ASCE International Workshop on Computing in Civil Engineering; 2017. p. 358-65.

Tarun D, Srikanth VM, Kumar RJ, Anudeep IM, Srikanth S. Stress analysis on a chairless chair. Int J Theor Appl Mech. 2017;12(4):699-708.

Naidu TY. Design and improvement of lower body exoskeleton. Mech Syst Des. 2016; 5:1-8.

Prall J, Ross M. The management of work-related musculoskeletal injuries in an occupational health setting: The role of the physical therapist. J Exerc Rehabil. 2019;15(2):193-9. https://doi.org/10.12965/jer.1836636.318 PMid:31111000 DOI: https://doi.org/10.12965/jer.1836636.318

Ellegast RP, Kraft K, Groenesteijn L, Krause F, Berger H, Vink P. Comparison of four specific dynamic office chairs with a conventional office chair: Impact upon muscle activation, physical activity and posture. Appl Ergon. 2012;43(2):296-307. https://doi.org/10.1016/j.apergo.2011.06.005 PMid:21714953 DOI: https://doi.org/10.1016/j.apergo.2011.06.005

Carrillo-Castrillo JA, Pérez-Mira V, Del Carmen Pardo-Ferreira M, Rubio-Romero JC. Analysis of required investigations of workrelated musculoskeletal disorders in Spain. Int J Environ Res Public Health. 2019;16(10):1682. https://doi.org/10.3390/ijerph16101682 PMid:31091722 DOI: https://doi.org/10.3390/ijerph16101682

Choi M, Kim HR, Lee J, Lee HE, Byun J, Won JU. Workers’ experiences with compensated sick leave due to musculoskeletal disorder: A qualitative study. Ann Occup Environ Med. 2014;26(1):33. https://doi.org/10.1186/s40557-014-0033-0 PMid:25852943 DOI: https://doi.org/10.1186/s40557-014-0033-0

Tuncel S, Genaidy A, Shell R, Salem S, Karwowski W, Darwish M, et al. Research to practice: Effectiveness of controlled workplace interventions to reduce musculoskeletal disorders in the manufacturing environment-critical appraisal and metaanalysis. Hum Factors Ergon Manuf. 2008;18(2):93-124. DOI: https://doi.org/10.1002/hfm.20104

Abidin Z, Fadhlurrahman IG, Akbar I, Putra RU, Prakoso AP, Kadir MZ, et al. Numerical Investigation of the Mechanical Properties of 3D Printed PLA Scaffold. Proc. 5th FIRST T1 T2 2021 Int. Conf. (FIRST-T1-T2 2021). 2022;9: 83-89. https://doi.org/10.2991/ahe.k.220205.015 DOI: https://doi.org/10.2991/ahe.k.220205.015

Patel MS, Lee KC, Dhake RP, Longworth S, Sell P. Ability of spine specialists to identify psychosocial risk factors as obstacles to recovery in patients with low back pain-related disorders. Asian Spine J. 2021;15(2):224-33. https://doi.org/10.31616/asj.2019.0377 PMid:32703922 DOI: https://doi.org/10.31616/asj.2019.0377

Roudsari B, Jarvik JG. Lumbar spine MRI for low back pain: Indications and yield. Am J Roentgenol. 2010;195(3):550-9. https://doi.org/10.2214/AJR.10.4367 PMid:20729428 DOI: https://doi.org/10.2214/AJR.10.4367

Fayad F, Lefevre-Colau MM, Gautheron V, Macé Y, Fermanian J, Mayoux-Benhamou A, et al. Reliability, validity and responsiveness of the French version of the questionnaire quick disability of the arm, shoulder and hand in shoulder disorders. Man Ther. 2009;14(2):206-12. https://doi.org/10.1016/j.math.2008.01.013 PMid:18436467 DOI: https://doi.org/10.1016/j.math.2008.01.013

Shaik A, Sripathi Rao B, Husain A, D′sa J. Work-related musculoskeletal disorders among dental surgeons: A pilot study. Contemp Clin Dent. 2011;2(4):308-12. https://doi.org/10.4103/0976-237X.91794 PMid:22346158 DOI: https://doi.org/10.4103/0976-237X.91794

Rafie F, Jam AZ, Shahravan A, Raoof M, Eskandarizadeh A. Prevalence of upper extremity musculoskeletal disorders in dentists: Symptoms and risk factors. J Environ Public Health. 2015;2015:517346. https://doi.org/10.1155/2015/517346 PMid:26064141 DOI: https://doi.org/10.1155/2015/517346

Ganer N. Work Related Musculoskeletal Disorders Among Healthcare Professional and Their Preventive Measure: A Report. Vol. 4; 2016. p. 693-8.

Aghilinejad M, Ehsani AA, Talebi A, Koohpayehzadeh J, Dehghan N. Ergonomic risk factors and musculoskeletal symptoms in surgeons with three types of surgery: Open, laparoscopic, and microsurgery. Med J Islam Repub Iran. 2016;30(1):467. PMid:28491842

Lin TH, Liu YC, Hsieh TY, Hsiao FY, Lai YC, Chang CS. Prevalence of and risk factors for musculoskeletal complaints among Taiwanese dentists. J Dent Sci. 2012;7(1):65-71. https://doi.org/10.1016/j.jds.2012.01.009 DOI: https://doi.org/10.1016/j.jds.2012.01.009

Akbar I, Prakoso AT, Astrada YM, Sinaga MS, Ammarullah MI, Adanta D, et al. Permeability Study of Functionally Graded Scaffold Based on Morphology of Cancellous Bone. Malaysian J Med Health Sci. 2021;17 Suppl 13:60-66.

Matern U. Ergonomic deficiencies in the operating room: Examples from minimally invasive surgery. Work. 2009;33(2):165-8. https://doi.org/10.3233/WOR-2009-0862 PMid:19713625 DOI: https://doi.org/10.3233/WOR-2009-0862

Lowndes BR, Hallbeck MS. Overview of human factors and ergonomics in the OR, with an emphasis on minimally invasive surgeries. Hum Factors Ergon Manuf. 2014;24(3):308-17. DOI: https://doi.org/10.1002/hfm.20383

Seetharaman R, Thattil RS, Visal P, Vijesh VM, Sanjay V. Design, Analysis and Development of Chairless Chair Exoskeleton System. Vol. 588. Kerala: Nehru College of Engineering and Research Center; 2018.

Shouhed D, Gewertz B, Wiegmann D, Catchpole K. Integrating human factors research and surgery: A review. Arch Surg. 2012;147(12):1141-6. https://doi.org/10.1001/jamasurg.2013.596 PMid:23248019 DOI: https://doi.org/10.1001/jamasurg.2013.596

Yule S, Flin R, Paterson-Brown S, Maran N. Non-technical skills for surgeons in the operating room: A review of the literature. Surgery. 2006;139(2):140-9. https://doi.org/10.1016/j.surg.2005.06.017 PMid:16455321 DOI: https://doi.org/10.1016/j.surg.2005.06.017

Mishra A, Catchpole K, Dale T, McCulloch P. The influence of non-technical performance on technical outcome in laparoscopic cholecystectomy. Surg Endosc Other Interv Tech. 2008;22(1):68-73. https://doi.org/10.1007/s00464-007-9346-1 PMid:17479324 DOI: https://doi.org/10.1007/s00464-007-9346-1