A pilot study comparing ergonomics in laparoscopy and robotics: beyond anecdotes and subjective claims

Abstract

Background: Minimally-invasive surgery has been shown to more demanding on the surgeon than open surgery. This can be manifested as physical fatigue and impaired dexterity, affecting the performance of the surgeon. In this study, we aimed to use hand dexterity and grip strength test as objective measures to compare the difference in surgeon fatigue associated with robotic and laparoscopic colorectal surgery. Methods: A pilot study was conducted between February 2019 and May 2019, recruiting consecutive colorectal patients operated on by a single surgeon using laparoscopy or robotics. We used the Purdue Pegboard Test (PBT) to assess hand dexterity, and the Camry Electronic Handgrip Dynamometer to assess hand grip strength. Before each operative procedure, the surgeon was tasked to perform both tests in a standardized sequence. These tests were repeated two hours into surgery.Results: Eighteen patients were operated on, including 10 robotic and 8 laparoscopic cases. Statistical analysis revealed no difference in dexterity or muscle fatigue after operating with the robot. In contrast, there was a significant difference in the hand grip strength of both hands after laparoscopic surgery (P = 0.04 and 0.02, respectively).Conclusions: Our results show that the resultant fatigue after laparoscopy affects both hands of the surgeon. In contrast, there was no difference in dexterity or muscle fatigue after operating with the robot. Given the demands of complex colorectal surgeries, robotics may be a means of optimizing surgeon performance by reducing fatigue.

Ergonomic analysis of hand dysfunction in endoscopic sinus surgery

“…The results of this study demonstrated a significant decrease in mean grip strength of 2.51 kg in the right hand and 2.81 kg in the left hand after performing endoscopic sinonasal procedures. Although this study only required 30 min of operating time, these results are comparable to an analogous study where general surgeons performing laparoscopic surgery for 2 h experienced 2.2 and 3.3 kg decreased mean grip strength in the right and left hands, respectively 2 . For reference, studies in the hand and rehabilitation literature have shown minimum clinically important differences in grip strength of 12.1 kg at 3 months after distal radius fracture, 5.0–6.2 kg early after stroke, and 0.84–1.2 kg in women with carpometacarpal osteoarthritis of the thumb 6 .…”

“…Subjects completed a battery of subjective and objective evaluations before and after performing sinus surgery, similar to an established protocol 2 . Subjective evaluation of hand function and discomfort included a modified Disabilities of the Arm, Shoulder, and Hand (mDASH) questionnaire 3 which was adapted to focus on the wrist, hands, and fingers.…”

Cirurgia laparoscópica versus cirurgia robótica: uma revisão integrativa

“…A expansão do mercado de plataformas robóticas também tem implicações para o treinamento em cirurgia robótica (Ramirez Barriga;Rojas;Roggin;Talamonti et al, 2022). Outra área potencial de benefício é o conforto e a fadiga do cirurgião, já que a posição mais ergonômica da cirurgia robótica pode reduzir a fadiga e a dor musculoesquelética (Kuo;Ngu;Lin;Chen et al, 2020).…”