Thursday, 28 January 2021

Exoskeleton provides relief for surgeons in the operating theatre

The Paexo Shoulder exoskeleton – worn under a surgical gown – relieves Dr Veit Rohde’s arm and shoulder muscles when he performs longer neurosurgical operations.

Paexo Shoulder makes operating more ergonomic and precise for doctors

Surgeons often have to hold static positions many for hours during operations, and twisting the upper body and neck, keeping their arms continuously raised and making repetitive movements places strains on their muscles and joints. As a result, their bodies become fatigued, increasing the risk of work-related illnesses. According to studies, 68% of surgeons report that they experience general pain and complaints affecting the back (50%), neck (48%) and arms or shoulders (43%)[1] – especially during minimally invasive surgery[2]. In many cases, they need to seek treatment themselves, miss work or even retire early due to the symptoms they experience as a result of their work.

Industrial exoskeleton used during surgery for the first time

“The field of neurosurgery is constantly looking for new ideas to improve ergonomics in the operating theatre,” says Dr Veit Rohde, Clinical Director of Neurosurgery at Göttingen University Medical Centre. “Since the beginning of 2020, we have been testing an industrial exoskeleton that supports the position of the arms during micro-surgical operations, for instance involving the posterior fossa. The results have been very positive: When I wear the Paexo Shoulder, the muscles in my arms and shoulders don’t get as tired, and I can work at the same high level of surgical precision even when performing longer operations.”

Paexo Shoulder was developed by medtech company Ottobock to create healthier workplaces in the industry and trade sectors. Since the spring of 2020, the exoskeleton has been supporting surgeons at hospitals in Germany, Switzerland and the Netherlands for the first time: “The doctors wear the Paexo Shoulder close to the body, similar to a backpack. The exoskeleton transfers the weight of the user’s raised arms via the arm shells to the hips using mechanical cable pull technology,” explains Dr Sönke Rössing, Head of Ottobock Industrials.

Because it is a passive exoskeleton, the Paexo Shoulder does not require any energy supply – making it the lightest exoskeleton of its kind with a weight of under two kilograms. The design is geared towards natural human movements, so surgeons can easily walk, sit and reach for instruments while wearing the exoskeleton under a surgical gown. This also ensures that sterile conditions are maintained during surgery.

Hospitals wishing to test the Paexo Shoulder exoskeleton in practice can order a test package starting at 1,900 euros. A team of ergonomics experts from the Ottobock Industrials team oversees the implementation at the workplace and provides advice to the participating doctors.

Ottobock exoskeletons

Since 2012, Ottobock has been researching solutions to provide relief for people who perform physically demanding tasks, thereby creating healthier working conditions. The company offers a wide range of passive exoskeletons and ergonomics solutions such as Paexo Back to relieve the back, Paexo Shoulder and Paexo Neck to assist with overhead work, and the Paexo Thumb and Paexo Wrist to relieve the thumb or wrist.

Interested parties can obtain a personal quote and further details by e-mail ( or phone (+49 5527 848-1482). Further information is available at

Photos and captions:

Photo 1: The Paexo Shoulder exoskeleton – worn under a surgical gown – relieves Dr Veit Rohde’s arm and shoulder muscles when he performs longer neurosurgical operations. © Neurosurgery Clinic, Göttingen University Hospital/NCHI

Photo 2: It takes less than 20 seconds for Dr Veit Rohde to put on the Paexo Shoulder exoskeleton before an operation. © Neurosurgery Clinic, Göttingen University Hospital/NCHI

Photo 3: Prof. Dr. Marcos Tatagiba, Director of the Department of Neurosurgery at the University Hospital of Tübingen, testing the Paexo Shoulder during an operation in a semi-sitting position. The Paexo Shoulder supports the steady posture of the arms and shoulders while using the surgical microscope. © Clinic for Neurosurgery of the University Hospital Tübingen

[1] Chee-Chee H. Stucky, Kate D. Cromwell, Rachel K. Voss, Yi-Ju Chiang, Karin Woodman, Jeffrey E. Lee, Janice N. Cormier (2018): Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics. Annals of Medicine and Surgery, Volume 27, 1-8.

[2] Maria C. Gutierrez-Diez, Maria A. Benito-Gonzalez, Ramon Sancibrian, Marco A. Gandarillas-Gonzalez, Carlos Redondo-Figuero & Jose C. Manuel-Palazuelos (2018): A study of the prevalence of musculoskeletal disorders in surgeons performing minimally invasive surgery. International Journal of Occupational Safety and Ergonomics, 24:1, 111-117.

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