An assessment of the physical impact of complex surgical tasks on surgeon errors and discomfort: a comparison between robot‐assisted, laparoscopic and open approaches

Elhage, Oussama; Challacombe, Benjamin; Shortland, Adam; Dasgupta, Prokar

doi:10.1111/bju.12680

Cited by 42 publications

(25 citation statements)

References 27 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have suggested that surgeons experience more musculoskeletal discomfort during minimally invasive surgery [2, 5, 13, 40]. However, we did not observe a higher number of musculoskeletal complaints among surgeons who perform more endoscopic surgeries compared with surgeons who perform more open surgeries.…”

Section: Discussioncontrasting

confidence: 88%

“…Respondents in both groups seemed to suffer of complaints (now or in the past). This discrepancy could, for example, be due to the fact that other studies categorize surgeons as solely laparoscopic surgeons when they are regularly involved in laparoscopic surgeries [2] or because of the variance in prior surgical experience [40]. This could lead to a higher number of surgeons categorized as ‘laparoscopic’, with musculoskeletal complaints.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ergonomics in the operating room

et al. 2016

View full text Add to dashboard Cite

BackgroundSince the introduction of minimally invasive surgery, surgeons appear to be experiencing more occupational musculoskeletal injuries. The aim of this study is to investigate the current frequency and effects of occupational musculoskeletal injuries on work absence.MethodsAn online questionnaire was conducted among all surgeons affiliated to the Dutch Society for Endoscopic Surgery, Gastrointestinal Surgery, and Surgical Oncology. In addition, this survey was conducted among surgeons, gynaecologists, and urologists of one cluster of training hospitals in the Netherlands.ResultsThere were 127 respondents. Fifty-six surgeons currently suffer from musculoskeletal complaints, and 30 have previously suffered from musculoskeletal complaints with no current complaints. Frequently reported localizations were the neck (39.5 %), the erector spinae muscle (34.9 %), and the right deltoid muscle (18.6 %). Most of the musculoskeletal complaints were present while operating (41.8 %). Currently, 37.5 % uses medication and/or therapy to reduce complaints. Of surgeons with past complaints, 26.7 % required work leave and 40.0 % made intraoperative adjustments. More surgeons with a medical history of musculoskeletal complaints have current complaints (OR 6.1, 95 % CI 1.9–19.6). There were no significant differences between surgeons of different operating techniques in localizations and frequency of complaints, or work leave.ConclusionsDespite previous various ergonomic recommendations in the operating room, the current study demonstrated that musculoskeletal complaints and subsequent work absence are still present among surgeons, especially among surgeons with a positive medical history for musculoskeletal complaints. Even sick leave was necessary to fully recover. There were no significant differences in reported complaints between surgeons of different operating techniques. Almost half of the respondents with complaints made intraoperative ergonomic adjustments to prevent future complaints. The latter would be interesting for future research.

show abstract

Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Ergonomics in the operating room

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The more comfortable operating system may cause less fatigue to the surgeon as compared to laparoscopic methods, thereby leading to fewer errors. This was shown by Elhage et al (36) where time taken to perform a suturing task was not only shorter compared to laparoscopic and open, but there were also fewer errors made when compared to the laparoscopic method. The major limitation of this study is the possibility of bias.…”

Section: Discussionmentioning

confidence: 74%

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Fonseka

Ahmed

Froghi

et al. 2015

Arch Ital Urol Androl

Self Cite

View full text Add to dashboard Cite

Objective: To conduct a systematic review and meta-analysis comparing outcomes between Open Radical Cystectomy (ORC), Laparoscopic Radical Cystectomy (LRC) and Robot-assisted Radical Cystectomy (RARC). RARC is to be compared to LRC and ORC and LRC compared to ORC. Material and methods: A systematic review of the literature was conducted, collating studies comparing RARC, LRC and ORC. Surgical and oncological outcome data were extracted and a meta-analysis was performed. Results: Twenty-four studies were selected with total of 2,104 cases analyzed. RARC had a longer operative time (OPT) compared to LRC with no statistical difference between length of stay (LOS) and estimated blood loss (EBL). RARC had a significantly shorter LOS, reduced EBL, lower complication rate and longer OPT compared to ORC. There were no significant differences regarding lymph node yield (LNY) and positive surgical margins (PSM.) LRC had a reduced EBL, shorter LOS and increased OPT compared to ORC. There was no significant difference regarding LNY. Conclusion: RARC is comparable to LRC with better surgical results than ORC. LRC has better surgical outcomes than ORC. With the unique technological features of the robotic surgical system and increasing trend of intra-corporeal reconstruction it is likely that RARC will become the surgical option of choice. SummaryNo conflict of interest declared. my (RARC) has since emerged as a viable alternative. RARC has been reported to be associated with fewer complications compared to LRC (2) and the appeal of the robotic surgical system has led to the adoption of the procedure worldwide. However the production of high-quality evidence that measures the relative merits of ORC, LRC and RARC is lacking with surgeons having to rely on systematic review. This article aims to compare surgical and oncological outcomes of ORC, LRC and RARC. METHODS Eligibility criteriaData were collected on all patients over the age of 60 with muscle-invasive bladder cancer undergoing RARC, LRC or ORC. Surgical outcomes were; operative time (OPT), estimated blood loss (EBL), length of stay (LOS) and complication rate 90 days post-operatively. Oncological outcomes were; lymph node yield (LNY) and positive surgical margins (PSM). Comparisons were made between RARC, LRC and ORC and the outcomes of interest measured included both surgical and oncological outcomes. The studies forming the current meta-analysis include comparative studies, either retrospective or prospective, as well as randomized control trials. For a study to be included in our analysis it had to fulfill the following criteria. The study had to: -Compare outcome measures of two or all three surgical techniques (ORC, LRC and RARC). -Use quantitative data for at least one outcome measure.-Be a high quality study.If it was one of two studies that were produced by the same institution, it was ensured the data were mutually exclusive. Studies were excluded if they: -Lacked reporting of the desired outcome measures listed above or presented the data in such a way that...

show abstract

“…The severity of problems reported by MIS surgeons varies, with most surgeons reporting neuromusculoskeletal symptoms during the MIS procedures [8] and others identifying symptoms that persist beyond the operative time [6,14] and extend beyond the work day [12]. Neuromusculoskeletal fatigue, impairment, and injuries have been shown to adversely affect MIS performance, patient safety, and surgeon career longevity [15][16][17][18][19][20]. The impact of suboptimal health on the ability of surgeons to perform quality MIS procedures is a major concern in hospitals worldwide [9,[21][22][23], prompting calls by medical practitioners and human factors engineers to request modification of the "hostile" and "dangerous" environment encountered by MIS surgeons [9,10,24,25].…”

Section: Introductionmentioning

confidence: 99%