Skip to main content
Erschienen in: Surgical Endoscopy 4/2017

11.08.2016

Surgeons’ physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study

verfasst von: G. I. Lee, M. R. Lee, I. Green, M. Allaf, M. R. Marohn

Erschienen in: Surgical Endoscopy | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

It is commonly believed that robotic surgery systems provide surgeons with an ergonomically sound work environment; however, the actual experience of surgeons practicing robotic surgery (RS) has not been thoroughly researched. In this ergonomics survey study, we investigated surgeons’ physical symptom reports and their association with factors including demographics, specialties, and robotic systems.

Methods

Four hundred and thirty-two surgeons regularly practicing RS completed this comprehensive survey comprising 20 questions in four categories: demographics, systems, ergonomics, and physical symptoms. Chi-square and multinomial logistic regression analyses were used for statistical analysis.

Results

Two hundred and thirty-six surgeons (56.1 %) reported physical symptoms or discomfort. Among those symptoms, neck stiffness, finger, and eye fatigues were the most common. With the newest robot, eye symptom rate was considerably reduced, while neck and finger symptoms did not improve significantly. A high rate of lower back stiffness was correlated with higher annual robotic case volume, and eye symptoms were more common with longer years practicing robotic surgery (p < 0.05). The symptom report rate from urology surgeons was significantly higher than other specialties (p < 0.05). Noticeably, surgeons with higher confidence and helpfulness levels with their ergonomic settings reported lower symptom report rates. Symptoms were not correlated with age and gender.

Conclusion

Although RS provides relatively better ergonomics, this study demonstrates that 56.1 % of regularly practicing robotic surgeons still experience related physical symptoms or discomfort. In addition to system improvement, surgeon education in optimizing the ergonomic settings may be necessary to maximize the ergonomic benefits in RS.
Literatur
6.
Zurück zum Zitat Khan MS, Shah SS, Hemel A, Rimington P, Dasgupta P (2008) Robotic-assisted radical cystectomy. Int J Med Robot Comput Assist Surg MRCAS 4(3):197–201. doi:10.1002/rcs.207 CrossRef Khan MS, Shah SS, Hemel A, Rimington P, Dasgupta P (2008) Robotic-assisted radical cystectomy. Int J Med Robot Comput Assist Surg MRCAS 4(3):197–201. doi:10.​1002/​rcs.​207 CrossRef
9.
Zurück zum Zitat Martino MA, Berger EA, McFetridge JT, Shubella J, Gosciniak G, Wejkszner T, Kainz GF, Patriarco J, Thomas MB, Boulay R (2014) A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches. J Minim Invasive Gynecol 21(3):389–393. doi:10.1016/j.jmig.2013.10.008 CrossRefPubMed Martino MA, Berger EA, McFetridge JT, Shubella J, Gosciniak G, Wejkszner T, Kainz GF, Patriarco J, Thomas MB, Boulay R (2014) A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches. J Minim Invasive Gynecol 21(3):389–393. doi:10.​1016/​j.​jmig.​2013.​10.​008 CrossRefPubMed
11.
12.
Zurück zum Zitat Cichon R, Kappert U, Schneider J, Schramm I, Gulielmos V, Tugtekin SM, Schuler S (2000) Robotic-enhanced arterial revascularization for multivessel coronary artery disease. Ann Thorac Surg 70(3):1060–1062CrossRefPubMed Cichon R, Kappert U, Schneider J, Schramm I, Gulielmos V, Tugtekin SM, Schuler S (2000) Robotic-enhanced arterial revascularization for multivessel coronary artery disease. Ann Thorac Surg 70(3):1060–1062CrossRefPubMed
14.
Zurück zum Zitat Melfi FM, Fanucchi O, Davini F, Romano G, Lucchi M, Dini P, Ambrogi MC, Mussi A (2014) Robotic lobectomy for lung cancer: evolution in technique and technology. Eur J Cardio Thorac Surg. doi:10.1093/ejcts/ezu079 Melfi FM, Fanucchi O, Davini F, Romano G, Lucchi M, Dini P, Ambrogi MC, Mussi A (2014) Robotic lobectomy for lung cancer: evolution in technique and technology. Eur J Cardio Thorac Surg. doi:10.​1093/​ejcts/​ezu079
15.
Zurück zum Zitat Richmon JD, Quon H, Gourin CG (2014) The effect of transoral robotic surgery on short-term outcomes and cost of care after oropharyngeal cancer surgery. Laryngoscope 124(1):165–171. doi:10.1002/lary.24358 CrossRefPubMed Richmon JD, Quon H, Gourin CG (2014) The effect of transoral robotic surgery on short-term outcomes and cost of care after oropharyngeal cancer surgery. Laryngoscope 124(1):165–171. doi:10.​1002/​lary.​24358 CrossRefPubMed
19.
Zurück zum Zitat Eckstein FS, Bonilla LF, Schaff H, Englberger L, Windecker S, Hindrichs P, Carrel TP (2002) Two generations of the St. Jude Medical ATG coronary connector systems for coronary artery anastomoses in coronary artery bypass grafting. Ann Thorac Surg 74(4):S1363–S1367CrossRefPubMed Eckstein FS, Bonilla LF, Schaff H, Englberger L, Windecker S, Hindrichs P, Carrel TP (2002) Two generations of the St. Jude Medical ATG coronary connector systems for coronary artery anastomoses in coronary artery bypass grafting. Ann Thorac Surg 74(4):S1363–S1367CrossRefPubMed
20.
Zurück zum Zitat Manchana T, Sirisabya N, Vasuratna A, Termrungruanglert W, Tresukosol D, Wisawasukmongchol W (2014) Feasibility and safety of robotic surgery for gynecologic cancers. Asian Pac J Cancer Prev 15(13):5359–5364CrossRefPubMed Manchana T, Sirisabya N, Vasuratna A, Termrungruanglert W, Tresukosol D, Wisawasukmongchol W (2014) Feasibility and safety of robotic surgery for gynecologic cancers. Asian Pac J Cancer Prev 15(13):5359–5364CrossRefPubMed
23.
Zurück zum Zitat Lee J, Kang SW, Jung JJ, Choi UJ, Yun JH, Nam KH, Soh EY, Chung WY (2011) Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol 18(9):2538–2547. doi:10.1245/s10434-011-1628-0 CrossRefPubMed Lee J, Kang SW, Jung JJ, Choi UJ, Yun JH, Nam KH, Soh EY, Chung WY (2011) Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol 18(9):2538–2547. doi:10.​1245/​s10434-011-1628-0 CrossRefPubMed
24.
Zurück zum Zitat Franasiak J, Ko EM, Kidd J, Secord AA, Bell M, Boggess JF, Gehrig PA (2012) Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol 126(3):437–442. doi:10.1016/j.ygyno.2012.05.016 CrossRefPubMed Franasiak J, Ko EM, Kidd J, Secord AA, Bell M, Boggess JF, Gehrig PA (2012) Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol 126(3):437–442. doi:10.​1016/​j.​ygyno.​2012.​05.​016 CrossRefPubMed
26.
Zurück zum Zitat Plerhoples TA, Hernandez-Boussard T, Wren SM (2012) The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. J Robot Surg 6:65–72CrossRefPubMed Plerhoples TA, Hernandez-Boussard T, Wren SM (2012) The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. J Robot Surg 6:65–72CrossRefPubMed
28.
Zurück zum Zitat Lee EC, Rafiq A, Merrell R, Ackerman R, Dennerlein JT (2005) Ergonomics and human factors in endoscopic surgery: a comparison of manual vs telerobotic simulation systems. Surg Endosc 19(8):1064–1070. doi:10.1007/s00464-004-8213-6 CrossRefPubMed Lee EC, Rafiq A, Merrell R, Ackerman R, Dennerlein JT (2005) Ergonomics and human factors in endoscopic surgery: a comparison of manual vs telerobotic simulation systems. Surg Endosc 19(8):1064–1070. doi:10.​1007/​s00464-004-8213-6 CrossRefPubMed
29.
Zurück zum Zitat Stefanidis D, Wang F, Korndorffer JR Jr, Dunne JB, Scott DJ (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24(2):377–382. doi:10.1007/s00464-009-0578-0 CrossRefPubMed Stefanidis D, Wang F, Korndorffer JR Jr, Dunne JB, Scott DJ (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24(2):377–382. doi:10.​1007/​s00464-009-0578-0 CrossRefPubMed
30.
Zurück zum Zitat Stefanidis D, Hope WW, Scott DJ (2011) Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy. Surg Endosc 25(7):2141–2146. doi:10.1007/s00464-010-1512-1 CrossRefPubMed Stefanidis D, Hope WW, Scott DJ (2011) Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy. Surg Endosc 25(7):2141–2146. doi:10.​1007/​s00464-010-1512-1 CrossRefPubMed
31.
Zurück zum Zitat Hubert N, Gilles M, Desbrosses K, Meyer JP, Felblinger J, Hubert J (2013) Ergonomic assessment of the surgeon’s physical workload during standard and robotic assisted laparoscopic procedures. Int J Med Robot 9(2):142–147. doi:10.1002/rcs.1489 CrossRefPubMed Hubert N, Gilles M, Desbrosses K, Meyer JP, Felblinger J, Hubert J (2013) Ergonomic assessment of the surgeon’s physical workload during standard and robotic assisted laparoscopic procedures. Int J Med Robot 9(2):142–147. doi:10.​1002/​rcs.​1489 CrossRefPubMed
32.
Zurück zum Zitat Klein MI, Warm JS, Riley MA, Matthews G, Doarn C, Donovan JF, Gaitonde K (2012) Mental workload and stress perceived by novice operators in the laparoscopic and robotic minimally invasive surgical interfaces. J Endourol 26(8):1089–1094. doi:10.1089/end.2011.0641 CrossRefPubMed Klein MI, Warm JS, Riley MA, Matthews G, Doarn C, Donovan JF, Gaitonde K (2012) Mental workload and stress perceived by novice operators in the laparoscopic and robotic minimally invasive surgical interfaces. J Endourol 26(8):1089–1094. doi:10.​1089/​end.​2011.​0641 CrossRefPubMed
33.
Zurück zum Zitat van der Schatte Olivier RH, Van’t Hullenaar CD, Ruurda JP, Broeders IA (2009) Ergonomics, user comfort, and performance in standard and robot-assisted laparoscopic surgery. Surg Endosc 23(6):1365–1371. doi:10.1007/s00464-008-0184-6 CrossRefPubMed van der Schatte Olivier RH, Van’t Hullenaar CD, Ruurda JP, Broeders IA (2009) Ergonomics, user comfort, and performance in standard and robot-assisted laparoscopic surgery. Surg Endosc 23(6):1365–1371. doi:10.​1007/​s00464-008-0184-6 CrossRefPubMed
35.
Zurück zum Zitat Lee GI, Lee MR, Clanton T, Sutton E, Park AE, Marohn MR (2014) Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries. Surg Endosc 28(2):456–465. doi:10.1007/s00464-013-3213-z CrossRefPubMed Lee GI, Lee MR, Clanton T, Sutton E, Park AE, Marohn MR (2014) Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries. Surg Endosc 28(2):456–465. doi:10.​1007/​s00464-013-3213-z CrossRefPubMed
36.
Zurück zum Zitat Lawson LH, Curet MJ, Sanchez BR, Schuster R, Berguer R (2007) Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. J Robot Surg 1(1):61–67CrossRefPubMedPubMedCentral Lawson LH, Curet MJ, Sanchez BR, Schuster R, Berguer R (2007) Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. J Robot Surg 1(1):61–67CrossRefPubMedPubMedCentral
Metadaten
Titel
Surgeons’ physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study
verfasst von
G. I. Lee
M. R. Lee
I. Green
M. Allaf
M. R. Marohn
Publikationsdatum
11.08.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 4/2017
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5160-y

Weitere Artikel der Ausgabe 4/2017

Surgical Endoscopy 4/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.