Surgeons' posture and muscle strain during laparoscopic and robotic surgery

Area of Science:

• Surgical Technology
• Ergonomics
• Minimally Invasive Surgery

Background:

• Conventional laparoscopy (LAP) and robotic-assisted laparoscopic surgery (RALS) are common minimally invasive techniques.
• Surgeon comfort and physical exertion are critical factors in surgical performance and well-being.
• Differences in muscle workload and work posture between LAP and RALS are not fully understood.

Purpose of the Study:

• To compare muscle workload, work posture, and perceived physical exertion between LAP and RALS.
• To quantify surgeon physical demands during these two surgical modalities.
• To identify ergonomic advantages of RALS over LAP.

Main Methods:

• 13 colorectal surgeons performed one LAP and one RALS operation each.
• Surface electromyography (EMG) measured muscle activity in forearm, shoulder, and neck.
• Postural observations and perceived exertion ratings were recorded.

Main Results:

• LAP surgeons exhibited higher static, median, and peak forearm muscle activity than RALS surgeons.
• Peak muscle activity was higher during RALS, but LAP involved longer periods of low-intensity shoulder and neck muscle activity.
• RALS required less frequent changes in work posture compared to LAP.
• Perceived physical exertion was similar between LAP and RALS.

Conclusions:

• Minimally invasive surgery necessitates sustained static muscle activity and significant physical workload for surgeons.
• RALS appears to be less demanding on surgeon posture compared to conventional LAP.
• Further ergonomic optimization in minimally invasive surgery is warranted.