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Ergonomic Robotic Console Configuration in Gynecologic Surgery: An Interventional Study.
Erik D Hokenstad1, M Susan Hallbeck1, Bethany R Lowndes1
1Division of Urogynecology (Drs. Hokenstad and Occhino); Robert E. and Patricia D. Kern Center for the Science of Health Care Delivery (Drs. Hallbeck and Morrow); Department of Biomedical Statistics and Informatics (Ms. Weaver and Ms. McGree); Division of Gynecologic Oncology (Dr. Glaser), Mayo Clinic, Rochester, Minnesota; Department of Neurological Sciences (Dr. Lowndes), University of Nebraska Medical Center, Omaha, Nebraska.
An ergonomic intervention improved surgeon posture during robotic hysterectomy, significantly reducing time in risky neck and arm positions. This approach enhanced objective posture but did not significantly decrease reported musculoskeletal pain.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Occupational Health
Background:
- Robotic surgery offers numerous benefits but can lead to poor surgeon ergonomics and musculoskeletal discomfort.
- Optimizing console configuration is crucial for mitigating these risks.
- Previous studies highlight the need for standardized ergonomic protocols in robotic surgery.
Purpose of the Study:
- To pilot a methodology for optimizing robotic console configuration for improved ergonomic posture.
- To evaluate the impact of this ergonomic intervention on surgeon posture during robotic hysterectomy.
- To assess the effect of the intervention on surgeon-reported musculoskeletal discomfort.
Main Methods:
- A prospective cohort study involving six gynecologic surgeons performing robotic hysterectomies.
- Surgeons underwent a pre-intervention phase with self-selected console settings and a post-intervention phase with ergonomist-guided settings.
- Inertial measurement unit (IMU) sensors objectively measured body posture, and validated questionnaires assessed musculoskeletal pain.
Main Results:
- The ergonomic intervention significantly reduced the percentage of time spent in moderate- to high-risk neck (54.3% vs 21.0%) and right upper arm (15.5% vs 0.9%) postures.
- Average neck angle also decreased significantly post-intervention.
- While fewer surgeons reported increased neck and right shoulder pain post-intervention, these differences were not statistically significant.
Conclusions:
- An ergonomic robotic console intervention effectively improved objective surgeon posture.
- The optimized settings demonstrated a significant reduction in time spent in ergonomically risky positions.
- Further research is needed to establish a statistically significant link between improved posture and reduced pain.
