Muscle fatigue and physical discomfort reported by surgeons performing robotic-assisted surgery: a multinational survey

Patel, Ela; Saikali, Shady; Mascarenhas, Anya; Moschovas, Marcio Covas; Patel, Vipul

doi:10.1007/s11701-023-01608-9

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…Being able to optimize posture and relieve muscular load is what preserves the surgeon to operate for longer hours and for more years. Similar findings in terms of muscle groups affected by surgery were described by Patel et al, 8 who conducted a multinational survey, in which among 309 robotic surgeons who answered the questionnaire, the most common muscle groups of physical pain were the neck, shoulders, and back. A key difference to note, however, is the fact that a majority of the surgeons in that study attributed their muscular discomfort to the ergonomic design of the surgeon console, while we found that in the population surveyed in China, surgeon opinions were split.…”

Section: Discussionsupporting

confidence: 84%

“…The questionnaire used in this study was Google Forms based, consisting of 37 multiple choice, 3 short answer, and one open-ended question. This questionnaire was used in a previous study conducted by Patel et al 8 and was then translated from English to Mandarin, before being sent to more than 50 surgeons based in China via email. A total of 40 responses were received which we then reviewed and looked for the most commonly reported pain regions for these robotic surgeons.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

Saikali,

Patel,

Mascarenhas

et al. 2024

Surg Innov

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Introduction Robotic surgery has transformed minimally invasive procedures, offering precision and efficiency. However, the ergonomic aspects of robotic consoles and their impact on surgeon health remain understudied. This review investigates the burden of ergonomics and muscle fatigue among robotic surgeons in China, comparing the findings to a multinational study. Methodology A literature review identified themes related to physical discomfort in robotic surgery. A questionnaire was administered to Chinese robotic surgeons, yielding 40 responses. The study assessed demographic characteristics, surgeon experience, ergonomic practices, reported discomfort, and pain-relief mechanisms. Results The study revealed that most surgeons experienced shoulder and neck pain, with mixed opinions on whether robotic surgery was the primary cause. Stretching exercises were commonly used for pain relief. Surgeons believed that case volume and surgery duration contributed to discomfort. Comparisons with a multinational study suggested potential demographic and experience-related differences. Conclusion While the study has limitations, including a small sample size and potential translation issues, it underscores the importance of addressing ergonomic concerns and providing proper training to robotic surgeons to ensure their well-being and longevity in the field. Further research with larger cohorts and platform-specific analyses is warranted.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

Saikali,

Patel,

Mascarenhas

et al. 2024

Surg Innov

Self Cite

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“…It is important to introduce the nuanced aspects of the Hugo RAS system, since it comes with several merits, including the console-interface-improving ergonomics and different arm carts, which allow port placements according to the surgeons’ preference [ 23 ]. Several previously published studies have highlighted these ergonomic benefits, especially in mitigating surgeon discomfort, compared to the bury-in position of the DV platform [ 23 , 26 , 27 ]. The discomforts immediately after using the DV platform are more significant for surgeons with a high BMI (26–30 kg/m 2 ) [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several previously published studies have highlighted these ergonomic benefits, especially in mitigating surgeon discomfort, compared to the bury-in position of the DV platform [ 23 , 26 , 27 ]. The discomforts immediately after using the DV platform are more significant for surgeons with a high BMI (26–30 kg/m 2 ) [ 27 ]. Thus, such surgeons would benefit more if they successfully adapted to the Hugo RAS system.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms

Ou,

Marian,

et al. 2024

Cancers

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Objective: In a previous study, we proved that an experienced urologist is more likely to adapt to the Hugo RAS system. Based on this, we further examine various parameters in this study. Parameters included in this study consisted of console time, functional outcomes, and oncological outcomes. Materials and Methods: A total of 60 patients who underwent robot-assisted radical prostatectomy (RARP) performed by a single surgeon using the da Vinci (DV) system (n = 30) or the Hugo RAS system (n = 30) between March 2023 and August 2023 were included in the analysis. The intraoperative operative time was categorized into vesicourethral anastomosis time and overall console time. Functional and oncological outcomes were documented at the 1st and 3rd postoperative months. Parametric and non-parametric methods were adopted after checking skewness and kurtosis, and an α value of 5% was used to determine the significance. Results: The vesicourethral anastomosis time was significantly lengthened (Hedge’s g: 0.87; 95% confidence interval (CI): 0.34–1.39; J factor = 0.987). However, the overall console time was not affected. The functional (postoperative 3rd month: p = 0.130) and oncological outcomes (postoperative 3rd month: p = 0.103) were not significantly different. We also found that the adverse effect on surgical specimens and positive surgical margins was not affected (p = 0.552). Conclusion: During the process of adaptation, although intricate motions (such as the vesicourethral anastomosis time) would be lengthened, the overall console time would not change remarkably. In this process, the functional and oncological outcomes would not be compromised. This encourages urologists to adopt the Hugo RAS system in RARP if they have previous experiences of using the DV system, since their trifecta advantage would not be compromised.

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“…This affects cognitive function, decision making, and overall performance during surgery. By understanding muscle fatigue, ergonomic improvements can be made to surgical techniques and equipment design, and strategies can be implemented to mitigate its impact on surgeon well-being and surgical outcomes [ 27 ]. The results of the present study explore a comparison between conventional and robotic-assisted laparoscopic surgeries from the perspective of localized muscle fatigue and muscle activity.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery

Pérez-Salazar,

Caballero,

Sánchez-Margallo

et al. 2024

Sensors

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BACKGROUND: This study aims to implement a set of wearable technologies to record and analyze the surgeon’s physiological and ergonomic parameters during the performance of conventional and robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures. METHODS: This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion. Different wearable technologies were used to record the surgeons’ posture, muscle activity, electrodermal activity and electrocardiography signal during the surgical practice. RESULTS: The simulator study involved six surgeons: three experienced (>100 laparoscopic procedures performed; 36.33 ± 13.65 years old) and three novices (<100 laparoscopic procedures; 29.33 ± 8.39 years old). Three surgeons of different surgical specialties with experience in laparoscopic surgery (>100 laparoscopic procedures performed; 37.00 ± 5.29 years old), but without experience in surgical robotics, participated in the experimental model study. The participating surgeons showed an increased level of stress during the robotic-assisted surgical procedures. Overall, improved surgeon posture was obtained during robotic-assisted surgery, with a reduction in localized muscle fatigue. CONCLUSIONS: A set of wearable technologies was implemented to measure and analyze surgeon physiological and ergonomic parameters. Robotic-assisted procedures showed better ergonomic outcomes for the surgeon compared to conventional laparoscopic surgery. Ergonomic analysis allows us to optimize surgeon performance and improve surgical training.

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Muscle fatigue and physical discomfort reported by surgeons performing robotic-assisted surgery: a multinational survey

Cited by 5 publications

References 14 publications

Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery

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