Surgeons should be aware that their muscular fatigue levels will increase as an operation progresses; therefore, if possible, more complex parts of the operation should be performed as early as possible, or, in the case of a very long operation, a change in surgeon may be necessary.

Supporting the wrists significantly decreases the amplitude of the tremor. Surgeons should consider using wrist supports when performing parts of operations which necessitate a high degree of accuracy.

The objective of this prospective study, performed at two tertiary referral centers in the West Midlands, was to determine if operating has an effect on a surgeon's baseline tremor. A total of 10 head and neck surgery consultants, 2 ENT registrars and 19 normal controls participated in the study. The interventions were preoperative and postoperative tremor measurements for surgeons and pre and post-days' desk work for controls, with the main outcomes measure being the percentage change in tremor. No difference in baseline tremor was determined between consultants and registrars. Operating led to an increase in hand tremor in all subjects. Tremor increases in all subjects were directly proportional to the length of the time spent in operating. Operating compared to a normal day's desk work increased tremor by a factor of 8.4. In conclusion, surgeons should be aware that their tremor will increase as an operation progresses. More complex parts should be performed as early in the day as possible, or, in the case of a very long operation, a change of surgeons may occasionally be necessary.

Distributive tactile sensing is a method of tactile sensing in which a small number of sensors monitors the behaviour of a flexible substrate which is in contact with the object being sensed. This paper describes the first use of fibre Bragg grating sensors in such a system. Two systems are presented: the first is a one-dimensional metal strip with an array of four sensors, which is capable of detecting the magnitude and position of a contacting load. This system is favourably compared experimentally with a similar system using resistive strain gauges. The second system is a two-dimensional steel plate with nine sensors which is able to distinguish the position and shape of a contacting load, or the positions of two loads simultaneously. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact. Issues and limitations of the systems are discussed, along with proposed solutions to some of the difficulties.

The aim of this paper is to determine if operating has an effect on a surgeon's muscular fatigue and hand tremor. Electromyography and tremor measurements were taken throughout a day of operating from the brachioradialis (BR) and mid deltoid (MD) muscles of six head and neck surgery consultants and two Ear, Nose, and Throat (ENT) registrars. The percent change in Mean Frequency (MF) of their EMG signal and tremor amplitudes was compared to twenty normal controls performing desk work. It was found that operating led to an increase in the fatigue level and hand tremor in all subjects, compared to very little increase from within the controls study. It was also determined that the BR is used more than the MD muscle and hence fatigues at a faster rate. Surgeons should be aware that their muscular fatigue levels and consequently their hand tremor will increase as an operation progresses, therefore, if possible, more complex parts of the operation should be performed as early as possible.