Surgeons’ muscle load during robotic-assisted laparoscopy performed with a regular office chair and the preferred of two ergonomic chairs: A pilot study

Dalager, Tina; Jensen, Pernille Tine; Winther, Trine Straarup; Savarimuthu, Thiusius Rajeeth; Markauskas, Algirdas; Mogensen, Ole; Søgaard, Karen

doi:10.1016/j.apergo.2018.03.016

Cited by 22 publications

(16 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies looking at possible alleviating effects of ergonomic initiatives in LAP and RALS had contradictory results. The lack of a significant effect of ergonomic improvements may be explained by a number of studies reporting that surgeons do not utilize the ergonomic possibilities, or are even unaware of good ergonomic work practice.…”

Section: Discussionmentioning

confidence: 93%

Surgeons' posture and muscle strain during laparoscopic and robotic surgery

Dalager

Jensen

Eriksen

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background: It is assumed that conventional laparoscopy (LAP) and robotic-assisted laparoscopic surgery (RALS) differ in terms of the surgeon's comfort. This study compared muscle workload, work posture and perceived physical exertion of surgeons performing LAP or RALS.Methods: Colorectal surgeons with experience in advanced LAP and RALS performed one of each operation. Bipolar surface electromyography (EMG) recordings were made from forearm, shoulder and neck muscles, and expressed relative to EMG maximum (%EMG max ). The static, median and peak levels of muscle activity were calculated, and an exposure variation analysis undertaken. Postural observations were carried out every 10 min, and ratings of perceived physical exertion before and after surgery were recorded.Results: The study included 13 surgeons. Surgeons performing LAP showed higher static, median, and peak forearm muscle activity than those undertaking RALS. Muscle activity at peak level was higher during RALS than LAP. Exposure variation analysis demonstrated long-lasting periods of low-level intensity muscle activity in the shoulders for LAP, in the forearms for RALS, and in the neck for both procedures. Postural observations revealed a greater need for a change in work posture when performing LAP compared with RALS. Perceived physical exertion was no different between the surgical modalities.Conclusion: Minimally invasive surgery requires long-term static muscle activity with a high physical workload for surgeons. RALS is less demanding on posture. MethodsColorectal surgeons from two Danish hospitals participated. The surgeons were eligible if certified in both surgical modalities, had performed LAP and RALS almost equally, and had a high weekly caseload. The surgeons gave written informed consent to participate, and the Danish Data Protection Agency approved the study (record number 2015-57-0008). Approval from the regional ethics committee was sought, but the present study was exempted. Measurements were conducted on site during normal work procedures. Each surgeon performed two operations -one with LAP and one with RALS. Each of the procedures

show abstract

Section: Discussionmentioning

confidence: 93%

Surgeons' posture and muscle strain during laparoscopic and robotic surgery

Dalager

Jensen

Eriksen

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…This could have a major effect on scoring as evidence by an ergonomic training program for American gynecological surgeons that resulted in a 74% reduction in physical complaints among participants 24. Hardware development such as new generation of surgical robot or new ergonomic-specific chair25 should improve exertion score for the surgeons.…”

Section: Discussionmentioning

confidence: 99%

<p>An Ergonomic Assessment Of Four Different Donor Nephrectomy Approaches For The Surgeons And Their Assistants</p>

Marçon¹,

Sime²,

Guillemin³

et al. 2019

RRU

View full text Add to dashboard Cite

IntroductionOpen surgery is increasingly being replaced by laparoscopic approaches that are more demanding for the surgical team. The physical and mental workload of these approaches have not been quantified.Materials and methodsA multicenter prospective study was performed evaluating the physical and mental stresses of 4 surgical approaches (open surgery [OS], standard laparoscopy [SL], hand-assisted laparoscopy [HAL], and robot-assisted laparoscopy [RAL]) for donor nephrectomy for the surgeon and their assistant. The Borg Scale was used to evaluate exertion in different body parts every 30 mins during surgery and the NASA-TLX score was used to evaluate overall workload.Results264 nephrectomies were performed over a 33-month period and 258 questionnaires evaluating these surgeries were obtained. Surgeons experienced less left shoulder and arm exertion and left forearm and hand exertion, but greater lower back exertion, as measured by the Borg scale, with RAL. Leg exertion was significantly greater with OS. Assistant surgeons experienced increased exertion in the back, right shoulder and arm, and right forearm and hand with RAL. NASA Task load index (TLX) surgeon scores showed mental demand was similar for all 4 surgical approaches. Physical demand was lower and overall performance was higher with RAL.DiscussionFour different nephrectomy surgical approaches were evaluated in a multicenter setting. Surgeon and assistant scores of physical exertions were generally in the “easy” range but confirmed that robotic surgery is an ergonomic progress compared to other techniques, except for the axial skeleton. Further, it degrades the working conditions for the assistant.

show abstract

“…It is of course unrealistic to try to modify the length of such procedures but it has been shown that taking microbreaks may be of benefit for the scrubbed team and that this does not impact on length of surgery [9, 35, 36]. Other strategies to mitigate discomfort/pain which potentially leads to MSK injury or reduced career longevity include postural awareness using observation or wearable sensors, changing surgeons’ postures by performing some procedures standing and others seated [37–39], performing a variety of procedures to change the load periodically for the surgeon, placement of trocars or other means to optimize surgical approach, and using other interventions such as armrests or fixtures for retraction.…”

Section: Discussionmentioning

confidence: 99%

Operating hurts: a study of EAES surgeons

et al. 2018

View full text Add to dashboard Cite

Background Work-related pain and discomfort experienced by surgeons is widely reported in the literature. A survey was, therefore, conducted to explore this issue among members of the European Association for Endoscopic Surgery (EAES). Methods The survey was emailed to 2980 EAES members in 2017 enquiring about their working practice, musculoskeletal (MSK) pain and burnout. Results A total of 569 (19%) surgeons responded, of whom 556 were practicing surgeons; 86% were consultants, 84% were male, and 94% were right-handed. Respondents operated on average 3.3 days/week with 27% of their procedures lasting longer than 3 h. The 386 endoscopists surveyed reported performing an average of 5.3 procedures/day with 83% performing endoscopy at least once per week. Over half of practicing surgeons (62%) reported their worst pain score was 3 or higher (10-point scale) in the past 7 working days, encompassing 71% of their open, 72% laparoscopic, 48% robot-assisted cases and 52% of their endoscopies. Of the 120 surgeons who had ever sought medical help for aches, pain or discomfort, 38% were currently in pain and 16% had considered leaving surgery due to their MSK pain, 26% had reported work-related pain to their employer, 26% had been on short-term disability during their career and 4% long-term disability due to MSK disorders. A significant proportion of the respondents (49%) felt their physical discomfort would influence the ability to perform or assist with surgical procedures in the future. These surgeons reported significantly lower satisfaction from their work ( p = 0.024), higher burnout ( p = 0.005) and significantly higher callousness toward people ( p < 0.001) than those not fearing loss of career longevity. Conclusion The results show that MSK pain is prevalent amongst EAES members. Nearly half the respondents had career longevity fears from pain/discomfort which, in turn, correlated with more prevalent feelings of burnout. More emphasis should be placed on the aetiology, prevention and management of musculoskeletal pain in the surgical workforce.

show abstract

Surgeons’ muscle load during robotic-assisted laparoscopy performed with a regular office chair and the preferred of two ergonomic chairs: A pilot study

Cited by 22 publications

References 51 publications

Surgeons' posture and muscle strain during laparoscopic and robotic surgery

Surgeons' posture and muscle strain during laparoscopic and robotic surgery

<p>An Ergonomic Assessment Of Four Different Donor Nephrectomy Approaches For The Surgeons And Their Assistants</p>

Operating hurts: a study of EAES surgeons

Contact Info

Product

Resources

About