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“Alarm-corrected” ergonomic armrest use could improve learning curves of novices on robotic simulator

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In robotic surgery, the professional ergonomic habit of using an armrest reduces operator fatigue and increases the precision of motion. We designed and validated a pressure surveillance system (PSS) based on force sensors to investigate armrest use. The objective was to evaluate whether adding an alarm to the PSS system could shorten ergonomic training and improve performance.

Study design

Twenty robot and simulator-naïve participants were recruited and randomized in two groups (A and B). The PSS was installed on a robotic simulator, the dV-Trainer, to detect contact with the armrest. The Group A members completed three tasks on the dV-Trainer without the alarm, making 15 attempts at each task. The Group B members practiced the first two tasks with the alarm and then completed the final tasks without the alarm. The simulator provided an overall score reflecting the trainees’ performance. We used the new concept of an “armrest load” score to describe the ergonomic habit of using the armrest.


Group B had a significantly higher performance score (p < 0.001) and armrest load score (p < 0.001) than Group A from the fifth attempt of the first task to the end of the experiment.


Based on the conditioned reflex effect, the alarm associated with the PSS rectified ergonomic errors and accelerated professional ergonomic habit acquisition. The combination of the PSS and alarm is effective in significantly shortening the learning curve in the robotic training process.

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Kun Yang is supported by a fellowship provided by the China Scholarship Council for studies at Lorraine University, Nancy, France.

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Correspondence to Jacques Hubert.

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Drs. Kun Yang, Manuela Perez, Gabriela Hossu, Nicolas Hubert, Cyril Perrenot, and Jacques Hubert have no conflicts of interest or financial ties to disclose.

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Yang, K., Perez, M., Hossu, G. et al. “Alarm-corrected” ergonomic armrest use could improve learning curves of novices on robotic simulator. Surg Endosc 31, 100–106 (2017).

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