V Mendes1,2, Franck Bruyere3,4, Jean Michel Escoffre5, Aurelien Binet3,6, Hubert Lardy3,6, Henri Marret7,3, Frederic Marchal8, Thomas Hebert7. 1. Service d'Obstétrique, de Gynécologie et de Médecine Fœtale, Centre Hospitalier Régional de Tours, 2 boulevard Tonnellé, 37044, Tours Cedex 9, France. v.mendes@chu-tours.fr. 2. Université de Tours, 10 boulevard Tonnellé, BP 3223, 37032, Tours cedex 1, France. v.mendes@chu-tours.fr. 3. Université de Tours, 10 boulevard Tonnellé, BP 3223, 37032, Tours cedex 1, France. 4. Service d'Urologie et de Transplantation rénale, Centre Hospitalier Régional de Tours, 2 boulevard Tonnellé, Tours, France. 5. UMR 1253, iBrain, Université de Tours, Inserm, Tours, France. 6. Service de Chirurgie Pédiatrique, Centre Hospitalier Régional de Tours, 49 boulevard Beranger, 37044, Tours, France. 7. Service d'Obstétrique, de Gynécologie et de Médecine Fœtale, Centre Hospitalier Régional de Tours, 2 boulevard Tonnellé, 37044, Tours Cedex 9, France. 8. Service de Chirurgie Oncologique, Institut Cancérologie de Lorraine, Université de Lorraine, Vandoeuvre-les-Nancy, France.
Abstract
INTRODUCTION: Laparoscopic surgery (LS) may lead to musculoskeletal disorders (MSDs) and an increase in physical and mental workloads to the surgeon. Robot-assisted surgery (RAS) should improve the ergonomy of the surgeon. This study assesses the experience influence in surgical ergonomics between LS and RAS. METHODS: LS and RAS lasting more than 60 min of effective operative time were compared. During the surgical procedure, the physical discomfort was evaluated using the Borg scale. At the end, the mental workload was evaluated using the NASA-TLX index. After global analysis, the experienced and young surgeons were assessed. RESULTS: 88 RAS and 82 LS were evaluated. During LS, the physical discomfort was significantly higher in all segments, and the pain increased significantly during the procedure in all segments compared to that evaluated in the RAS (p < 0.05). Forearms and the back were the most painful. The young surgeons did not display any improvement in the physical ergonomics of the RAS compared to the LS. Concerning the mental ergonomics, the overall workload and performance were significantly greater during the LS compared to the RAS (p < 0.05). For the young surgeons, the overall workload, the effort, the mental and the physical demands were greater during LS (p < 0.05). For the experienced surgeons, the physical demand was lower during the RAS compared to the LS (p < 0.05). However, the experienced surgeons expressed a feeling of greater performance after the LS (p < 0.01). RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons. CONCLUSION: RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons.
INTRODUCTION: Laparoscopic surgery (LS) may lead to musculoskeletal disorders (MSDs) and an increase in physical and mental workloads to the surgeon. Robot-assisted surgery (RAS) should improve the ergonomy of the surgeon. This study assesses the experience influence in surgical ergonomics between LS and RAS. METHODS: LS and RAS lasting more than 60 min of effective operative time were compared. During the surgical procedure, the physical discomfort was evaluated using the Borg scale. At the end, the mental workload was evaluated using the NASA-TLX index. After global analysis, the experienced and young surgeons were assessed. RESULTS: 88 RAS and 82 LS were evaluated. During LS, the physical discomfort was significantly higher in all segments, and the pain increased significantly during the procedure in all segments compared to that evaluated in the RAS (p < 0.05). Forearms and the back were the most painful. The young surgeons did not display any improvement in the physical ergonomics of the RAS compared to the LS. Concerning the mental ergonomics, the overall workload and performance were significantly greater during the LS compared to the RAS (p < 0.05). For the young surgeons, the overall workload, the effort, the mental and the physical demands were greater during LS (p < 0.05). For the experienced surgeons, the physical demand was lower during the RAS compared to the LS (p < 0.05). However, the experienced surgeons expressed a feeling of greater performance after the LS (p < 0.01). RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons. CONCLUSION: RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons.
Entities:
Keywords:
Borg scale; Ergonomics; Laparoscopic surgery; NASA-TLX index; Robot-assisted surgery
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