Assessment of Muscle Activity with Laparoscopic Tools through EMG. Novel Proposal for Bivariate Amplitude-Frequency Analysis.

The progress of society is directing medicine towards minimally invasive approaches (MIA) intervention techniques. Sometimes, surgical instruments lack ergonomics, leading to injuries among healthcare personnel. The first aim of this study was to evaluate two laparoscopy tools, one of them used in clinical practice, and a prototype, using surface electromyography (sEMG) records from biceps, deltoid, trapezius, and flexor carpi radialis muscles were obtained from 17 volunteers through an isometric protocol. Temporal, spectral, and nonlinear parameters were calculated from sEMGs as biomarkers of muscle fatigue. Paired statistical studies were carried out to determine significant differences between tools and protocol positions. Subsequently, the study was extended through JASA analyses. A second goal was to propose a new bivariate analysis for muscle assessment considering other spectral and nonlinear parameters. sEMG biomarkers indicate a lower tendency towards the appearance of muscle fatigue with the prototype tool for biceps, deltoid, and trapezius muscles, and with the control tool for the flexor carpi radialis muscle. The new proposed bivariate analysis points out a more reliable characterization of muscular state than traditional JASA analyses.