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Surgical Endoscopy

, Volume 28, Issue 12, pp 3379–3384 | Cite as

Ergonomic analysis of robot-assisted and traditional laparoscopic procedures

  • Ahmed M. ZihniEmail author
  • Ikechukwu Ohu
  • Jaime A. Cavallo
  • Sohyung Cho
  • Michael M. Awad
Article

Abstract

Introduction

Many laparoscopic surgeons report musculoskeletal symptoms that are thought to be related to the ergonomic stress of performing laparoscopy. Robotic surgical systems may address many of these limitations. To date, however, there have been no studies exploring the quantitative ergonomics of robotic surgery. In this study, we sought to compare the activation of bilateral biceps, triceps, deltoid, and trapezius muscle groups during traditional laparoscopic surgery (TLS) and robot-assisted laparoscopic surgery (RALS) procedures, as quantified by surface electromyography (sEMG).

Methods

One surgeon with expertise in TLS and RALS performed 18 operative procedures (13 TLS, 5 RALS) while sEMG measurements were obtained from bilateral biceps, triceps, deltoid, and trapezius muscles. sEMG measurements were normalized to the maximum voluntary contraction of each muscle (%MVC). We compared mean %MVC values for each muscle group during TLS and RALS with unpaired t-tests and considered differences with a p value <0.05 to be statistically significant.

Results

Muscle activation was higher during TLS compared to RALS in bilateral biceps (L Biceps RALS:1.01 %MVC, L Biceps TLS:3.14, p = 0.01; R Biceps RALS:1.81 %MVC, R Biceps TLS:4.53, p = 0.0002). Muscle activation was higher during TLS compared to RALS in bilateral triceps (L Triceps RALS:1.73 %MVC, L Triceps TLS:3.58, p = 0.04; R Triceps RALS:1.59 %MVC, R Triceps TLS:5.11, p = 0.02). Muscle activation was higher during TLS compared to RALS in bilateral deltoids (L Deltoid RALS:1.50 %MVC, L Deltoid TLS:3.68, p = 0.03; R Deltoid RALS:1.19 %MVC, R Deltoid TLS:2.57, p = 0.01). Significant differences were not detected in the bilateral trapezius muscles (L Trapezius RALS:1.50 %MVC, L Trapezius TLS:3.68, p = 0.03; R Trapezius RALS:1.19 %MVC, R Trapezius TLS:2.57, p = 0.01).

Discussion

We have quantitatively examined the ergonomics of TLS and RALS and shown that in a single surgeon, TLS procedures are associated with significantly elevated biceps, triceps, and deltoid activation bilaterally when compared to RALS procedures.

Keywords

Ergonomics Robot-assisted surgery Laparoscopic surgery Human factors Electromyography 

Notes

Acknowledgments

The authors thank Gyusung Lee, PhD of the Department of Surgery at Johns Hopkins University (Baltimore, MD) for his valuable advice. This study was supported by research grants from the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) and Intuitive Surgical, Inc (Sunnyvale, CA).

Disclosures

This study was supported by a research grant from the Society of Gastrointestinal and Endoscopic Surgeons (SAGES). This study was supported by a research grant from Intuitive Surgical, Inc. (Sunnyvale, CA). Dr. Zihni received research grant funding for unrelated studies from the National Institutes of Health. Dr. Cavallo has received research grant funding for unrelated studies from the National Institutes of Health, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and the American Hernia Society in collaboration with Davol® Incorporated; and has served as a one-time consultant for Guidepoint Global® Incorporated. Dr Cho has received research grant funding from the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) and Intuitive, Surgical Inc. (Sunnyvale, CA). Dr Awad has received research grant funding from the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) and Intuitive, Surgical Inc. (Sunnyvale, CA). Mr. Ohu has no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ahmed M. Zihni
    • 1
    Email author
  • Ikechukwu Ohu
    • 2
  • Jaime A. Cavallo
    • 1
  • Sohyung Cho
    • 2
  • Michael M. Awad
    • 1
  1. 1.Department of Surgery, Section of Minimally Invasive SurgeryWashington University School of MedicineSt. LouisUSA
  2. 2.Department of Industrial and Manufacturing EngineeringSouthern Illinois University at EdwardsvilleEdwardsvilleUSA

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