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Comparative Study
. 2024 Jun 14;24(12):3840.
doi: 10.3390/s24123840.

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery

Manuel J Pérez-Salazar  1 , Daniel Caballero  1 , Juan A Sánchez-Margallo  1 , Francisco M Sánchez-Margallo  2
Affiliations
Comparative Study

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery

Manuel J Pérez-Salazar et al. Sensors (Basel). .

Abstract

Background: This study aims to implement a set of wearable technologies to record and analyze the surgeon's physiological and ergonomic parameters during the performance of conventional and robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures.

Methods: This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion. Different wearable technologies were used to record the surgeons' posture, muscle activity, electrodermal activity and electrocardiography signal during the surgical practice.

Results: The simulator study involved six surgeons: three experienced (>100 laparoscopic procedures performed; 36.33 ± 13.65 years old) and three novices (<100 laparoscopic procedures; 29.33 ± 8.39 years old). Three surgeons of different surgical specialties with experience in laparoscopic surgery (>100 laparoscopic procedures performed; 37.00 ± 5.29 years old), but without experience in surgical robotics, participated in the experimental model study. The participating surgeons showed an increased level of stress during the robotic-assisted surgical procedures. Overall, improved surgeon posture was obtained during robotic-assisted surgery, with a reduction in localized muscle fatigue.

Conclusions: A set of wearable technologies was implemented to measure and analyze surgeon physiological and ergonomic parameters. Robotic-assisted procedures showed better ergonomic outcomes for the surgeon compared to conventional laparoscopic surgery. Ergonomic analysis allows us to optimize surgeon performance and improve surgical training.

Keywords: general surgery; gynecology; localized muscle fatigue; minimally invasive surgery; motion analysis; muscle activity; simulation setting; stress level; urology; wearable device.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
VersiusTM Robotic Platform: instrument beside units (left) and surgeon console (right).
Figure 2
Figure 2
EdaMove 4 activity sensor placed on the surgeon’s ankle.
Figure 3
Figure 3
Example of location of EMG sensors (left) and inertial sensors for motion analysis (right).
Figure 4
Figure 4
Comparison of SURG-TLX parameters (mental demand, temporal demand, physical demand, stress, task complexity, and distractions), and EDA and ECG signal results during simulator tasks using conventional (CONV) and robotic-assisted (ROBOT) laparoscopy for novice and experienced laparoscopic surgeons. * p < 0.05.
Figure 5
Figure 5
Comparative range of motion of the neck, back, shoulder, elbow, wrist, and knees during laparoscopic (CONV) and robotic-assisted (ROBOT) suture on simulator. Group of novice surgeons in laparoscopic surgery.
Figure 6
Figure 6
Comparative range of motion of the neck, back, shoulder, elbow, wrist, and knees during laparoscopic (CONV) and robotic-assisted (ROBOT) suture on simulator. Group of experienced surgeons in laparoscopic surgery.
Figure 7
Figure 7
Comparison of muscle activity (%MVC) of experienced (upper image) and novice (bottom image) surgeons during performance of simulator suturing task using conventional (red) and robotic-assisted (blue) laparoscopic surgery for the following muscles: Brachioradialis (BRACH), Erector spinae (ER_SPIN), Gastrocnemius medialis (GAS_MED), Middle trapezius (MID_TRAP), Triceps brachii (TRI_BRA), Upper trapezius (UP_TRAP), and Vastus lateralis (VAS_LAT).
Figure 8
Figure 8
Comparison of fatigue and muscle strength increase/decrease for experienced (upper graph) and novice (bottom graph) surgeons between simulator suturing task in laparoscopic (red) and robotic-assisted (blue) surgeries.
Figure 9
Figure 9
Comparison of fatigue and force increasing/decreasing when performing suturing task in robotic-assisted (upper graph) and laparoscopic surgeries (bottom graph) between expert surgeons (blue) and novice surgeons (red).
Figure 9
Figure 9
Comparison of fatigue and force increasing/decreasing when performing suturing task in robotic-assisted (upper graph) and laparoscopic surgeries (bottom graph) between expert surgeons (blue) and novice surgeons (red).
Figure 10
Figure 10
Comparative range of motion of the neck, back, shoulder, elbow, wrist, and knees during conventional (CONV) and robotic-assisted (ROBOT) laparoscopic gastrotomy.
Figure 11
Figure 11
Comparative range of motion of the neck, back, shoulder, elbow, wrist, and knees during conventional (CONV) and robotic-assisted (ROBOT) laparoscopic total nephrectomy.
Figure 12
Figure 12
Comparative range of motion of the neck, back, shoulder, elbow, wrist, and knees during conventional (CONV) and robotic-assisted (ROBOT) laparoscopic total ovariectomy.
Figure 13
Figure 13
Comparison of muscle activity (%MVC) during the performance of a gastrotomy by conventional (red) and robotic-assisted (blue) laparoscopic surgeries for the following muscles: Brachioradialis (BRACH), Erector spinae (ER_SPIN), Gastrocnemius medialis (GAS_MED), Middle trapezius (MID_TRAP), Triceps brachii (TRI_BRA), Upper trapezius (UP_TRAP), and Vastus lateralis (VAS_LAT).
Figure 14
Figure 14
Comparison of muscle activity (%MVC) during the performance of a total nephrectomy by conventional (red) and robotic-assisted (blue) laparoscopic surgeries for the following muscles: Brachioradialis (BRACH), Erector spinae (ER_SPIN), Gastrocnemius medialis (GAS_MED), Middle trapezius (MID_TRAP), Triceps brachii (TRI_BRA), Upper trapezius (UP_TRAP), and Vastus lateralis (VAS_LAT).
Figure 15
Figure 15
Comparison of muscle activity (%MVC) during the performance of an ovariectomy by conventional (red) and robotic-assisted (blue) laparoscopic surgeries for the following muscles: Brachioradialis (BRACH), Erector spinae (ER_SPIN), Gastrocnemius medialis (GAS_MED), Middle trapezius (MID_TRAP), Triceps brachii (TRI_BRA), Upper trapezius (UP_TRAP), and Vastus lateralis (VAS_LAT).
Figure 16
Figure 16
Comparison of fatigue and increase/decrease in force exerted by surgeons during the performance of surgical procedures (circle: ovariectomy; triangle: total nephrectomy; square: gastrotomy) using conventional (red) and robotic-assisted (blue) laparoscopic surgeries.
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References

    1. Gabrielson A.T., Clifton M.M., Pavlovich C.P., Biles M.J., Huang M., Agnew J., Pierorazio P.M., Matlaga B.R., Bajic P., Schwen Z.R. Surgical ergonomics for urologists: A practical guide. Nat. Rev. Urol. 2021;18:160–169. doi: 10.1038/s41585-020-00414-4. - DOI - PubMed
    1. Müller D.T., Ahn J., Brunner S., Poggemeier J., Storms C., Reisewitz A., Schmidt T., Bruns C.J., Fuchs H.F. Ergonomics in robot-assisted surgery in comparison to open or conventional laparoendoscopic surgery: A narrative review. Int. J. Abdom. Wall Hernia Surg. 2023;6:61. doi: 10.4103/ijawhs.IJAWHS_52_22. - DOI
    1. Grantcharov P.D., Boillat T., Elkabany S., Wac K., Rivas H. Acute mental stress and surgical performance: Acute mental stress and surgical performance. BJS Open. 2019;3:119–125. doi: 10.1002/bjs5.104. - DOI - PMC - PubMed
    1. Wilson M.R., Poolton J.M., Malhotra N., Ngo K., Bright E., Masters R.S. Development and validation of a surgical workload measure: The surgery task load index (SURG-TLX) World J. Surg. 2011;35:1961–1969. doi: 10.1007/s00268-011-1141-4. - DOI - PMC - PubMed
    1. Nillahoot N., Pillai B.M., Sharma B., Wilasrusmee C., Suthakorn J. 3D Force/Torque parameter acquisition and correlation identification during primary trocar insertion in laparoscopic abdominal surgery: 5 cases. Sensors. 2022;22:8970. doi: 10.3390/s22228970. - DOI - PMC - PubMed

Publication types

Grants and funding

This work has been partially funded by the Regional Government of Extremadura, the Spanish Ministry of Science, Innovation and Universities, the European Social Fund, the European Regional Development Fund and European Union NextGenerationEU funds (grant numbers PD18077, TA18023, and GR21201), the Recovery, Transformation and Resilience Plan (PRTR-C17.I1), and the Extremadura ERDF Operational Program 2021–2027.