A systematic review of the true benefit of robotic surgery: Ergonomics

Abstract

BackgroundErgonomics, as defined by the optimization of one's physical environment to enhance work performance, is an important consideration in surgery. While there have been reviews on the ergonomics of laparoscopy, this has not been the case for robotic surgery despite the rising number of publications.MethodsThis study was performed in accordance to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines. A search was performed on main databases to identify relevant articles.ResultsTwenty‐nine articles were included, comprising 3074 participants. Studies employing objective measurement tools showed that robotics conferred superior ergonomic benefits and reduced work load compared to laparoscopy, for both surgeons and trainees. Survey studies also demonstrated that self‐reported discomfort was lower in robotic procedures compared to laparoscopy and open surgery. Compared to other subspecialities, gynecological procedures seem to be associated with greater surgeon‐reported strain.ConclusionRobotic surgery is ergonomically superior to open and laparoscopic surgery. However, rates of physical strain remain significant and should be addressed by formal ergonomic training and adequate console familiarization.

Perioperative and long-term outcomes of robot-assisted versus laparoscopy-assisted hemicolectomy for left-sided colon cancers: a retrospective study

“…Despite the disadvantages of longer operative times and higher cost, the robotic surgical system has some advantages, such as enlarged three-dimensional views, allowing flexibility of wrist movement, and filtering hand tremors, which allow surgeons to perform meticulous operations in a small space and make it convenient to deal with intraoperative emergencies such as bleeding. Besides, some studies have shown that robots conferred superior ergonomic benefits and reduced workloads for surgeons when compared to laparoscopy as well as can possibly optimize surgeon performance by reducing fatigue [19,20].…”

The Emerging Role of Robotics in Pelvic Exenteration Surgery for Locally Advanced Rectal Cancer: A Narrative Review

“…The operative workflow is delivered through mechatronically enhanced robotic Endo Wrists ® , which provide enhanced articulation beyond the limits of human wrist movements and eliminates human hand tremors, thus facilitating superior operative dexterity with augmented precision for surgical dissection while preserving stable tissue retraction ( Figure 1 ). The surgeon adopts a sitting posture in the robotic console, with adjustable settings of the viewer’s height and tilt, arm rest height, and the position of the pedal platform, collectively designed and demonstrated to improve the ergonomics of the operating surgeon when compared to laparoscopic surgery [ 17 ]. It is worth noting that similar feasibility studies demonstrating the safety and the potential advantages of robotic-assisted pelvic exenteration have also been reported in other tumour groups, such as recurrent endometrial and cervical cancers.…”

Single-docking robotic-assisted artery-guided segmental splenic flexure colectomy for splenic flexure cancer—a propensity score-matching analysis

“…The robotic-assisted ASFC did not present any advantage over the laparoscopic-assisted ASFC; however, it did provide surgeons with a better ergonomic experience (16). Catanzarite et al (17) reviewed the ergonomics of surgery, and found that work-related musculoskeletal disorders are common among surgeons, with rates of 66-94% for open surgery, 73-100% for conventional laparoscopy, 54-87% for vaginal surgery, and 23-80% for robotic-assisted surgery (17).…”