J Gynecol Oncol.  2017 Sep;28(5):e70. 10.3802/jgo.2017.28.e70.

Does a robotic surgery approach offer optimal ergonomics to gynecologic surgeons?: a comprehensive ergonomics survey study in gynecologic robotic surgery

Affiliations
  • 1Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA. mijalee71@gmail.com

Abstract


OBJECTIVE
To better understand the ergonomics associated with robotic surgery including physical discomfort and symptoms, factors influencing symptom reporting, and robotic surgery systems components recommended to be improved.
METHODS
The anonymous survey included 20 questions regarding demographics, systems, ergonomics, and physical symptoms and was completed by experienced robotic surgeons online through American Association of Gynecologic Laparoscopists (AAGL) and Society of Robotic Surgery (SRS).
RESULTS
There were 289 (260 gynecology, 22 gynecology-oncology, and 7 urogynecology) gynecologic surgeon respondents regularly practicing robotic surgery. Statistical data analysis was performed using the t-test, χ² test, and logistic regression. One hundred fifty-six surgeons (54.0%) reported experiencing physical symptoms or discomfort. Participants with higher robotic case volume reported significantly lower physical symptom report rates (p<0.05). Gynecologists who felt highly confident about managing ergonomic settings not only acknowledged that the adjustments were helpful for better ergonomics but also reported a lower physical symptom rate (p<0.05). In minimizing their symptoms, surgeons changed ergonomic settings (32.7%), took a break (33.3%) or simply ignored the problem (34%). Fingers and neck were the most common body parts with symptoms. Eye symptom complaints were significantly decreased with the Si robot (p<0.05). The most common robotic system components to be improved for better ergonomics were microphone/speaker, pedal design, and finger clutch.
CONCLUSION
More than half of participants reported physical symptoms which were found to be primarily associated with confidence in managing ergonomic settings and familiarity with the system depending on the volume of robotic cases. Optimal guidelines and education on managing ergonomic settings should be implemented to maximize the ergonomic benefits of robotic surgery.

Keyword

Robotic Surgical Procedures; Human Engineering; Surveys and Questionnaires; Medically Unexplained Symptoms; Gynecology

MeSH Terms

*Ergonomics/instrumentation/methods
Female
*Gynecologic Surgical Procedures/education
Humans
Male
Occupational Health
Robotic Surgical Procedures/*adverse effects/education
*Surgeons
*Surveys and Questionnaires
United States

Figure

  • Fig. 1. Robotic surgery system components for improvement. 3D, three-dimensional.

  • Fig. 2. Correlation between physical symptoms and annual robotic case volume.

  • Fig. 3. Correlation between physical symptoms and the confidence level in ergonomic setting management and the helpfulness level for better ergonomics.

  • Fig. 4. Correlation between the da Vinci robotic system generations and eye fatigue reporting. Standard, first generation; S, second generation; Si, third generation.


Reference

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