Experience implication in subjective surgical ergonomics comparison between laparoscopic and robot-assisted surgeries

Area of Science:

• Surgical Technology
• Occupational Health
• Ergonomics

Background:

• Laparoscopic surgery (LS) is associated with increased physical and mental workloads, potentially leading to musculoskeletal disorders (MSDs) for surgeons.
• Robot-assisted surgery (RAS) is proposed as a solution to improve surgeon ergonomics and mitigate these risks.

Purpose of the Study:

• To compare the surgical ergonomics between LS and RAS.
• To assess the influence of surgeon experience on the ergonomic benefits of RAS versus LS.

Main Methods:

• A comparative study evaluating 88 RAS and 82 LS procedures exceeding 60 minutes of operative time.
• Physical discomfort was measured using the Borg scale during surgery.
• Mental workload was assessed post-surgery using the NASA-TLX index.
• Analysis included global comparisons and stratification by surgeon experience (experienced vs. young).

Main Results:

• LS resulted in significantly higher physical discomfort across all body segments compared to RAS.
• Forearms and back reported the most pain during LS.
• Young surgeons showed no ergonomic improvement with RAS compared to LS.
• RAS led to significantly lower overall mental workload, effort, and demands for young surgeons compared to LS.
• Experienced surgeons reported lower physical demand with RAS, but paradoxically, higher perceived performance after LS.
• RAS demonstrated a significant reduction in MSDs compared to LS, particularly for experienced surgeons.

Conclusions:

• Robot-assisted surgery (RAS) offers significant ergonomic advantages over laparoscopic surgery (LS), notably reducing the incidence of musculoskeletal disorders (MSDs).
• The benefits of RAS in reducing physical strain are most pronounced in experienced surgeons, although perceived performance may differ.