Analysis of Surgeons’ Muscle Activity During the Use of a Handheld Robotic Instrument in Laparoendoscopic Single-Site Surgery
The objective of this study is to assess the surgeon’s performance and ergonomics during the use of a robotic-driven handheld laparoscopic instrument in intracorporeal suturing tasks as well as in digestive and urological laparoscopic procedures performed through single-site surgery, and comparing it with the use of conventional instruments. Seven right-handed experienced surgeons took part in this study. Four surgeons performed nine urethrovesical anastomoses on an ex vivo porcine model and three surgeons a partial nephrectomy and a sigmoidectomy on an in vivo animal model. Surgeons used both conventional laparoscopic instruments and the robotic instrument. Execution times, leakage pressure for the anastomosis, surgical complications and surgeons’ muscle activity were measured. Similar results in surgical performance and ergonomics were obtained using conventional laparoscopic instruments and the robotic instrument. Muscle activity of the biceps was significantly higher using the robotic instrument during both surgical procedures.
KeywordsLaparoendoscopic single-site surgery Handheld robotic instrument Ergonomics Muscle activity
This work has been partially funded by the Government of Extremadura, Spain, and the European Social Fund (PO14034).
- 4.Marks, J.H., Montenegro, G.A., Shields, M.V., Frenkel, J.L., Marks, G.J.: Single-port laparoscopic colorectal surgery shows equivalent or better outcomes to standard laparoscopic surgery: results of a 190-patient, 7-criterion case-match study. Surg. Endosc. 29, 1492–1499 (2014)CrossRefGoogle Scholar
- 8.Islam, A., Castellvi, A.O., Tesfay, S.T., Castellvi, A.D., Wright, A.S., Scott, D.J.: Early surgeon impressions and technical difficulty associated with laparoendoscopic single-site surgery: a Society of American gastrointestinal and endoscopic surgeons learning center study. Surg. Endosc. 25, 2597–2603 (2011)CrossRefGoogle Scholar
- 9.Rassweiler, J.J.: Is LESS/NOTES really more? Eur. Urol. 59, 46–8; discussion 48–50 (2011)Google Scholar
- 12.Pérez-Duarte, F.J., Lucas-Hernández, M., Matos-Azevedo, A., Sánchez-Margallo, J.A., Díaz-Güemes, I., Sánchez-Margallo, F.M.: Objective analysis of surgeons’ ergonomy during laparoendoscopic single-site surgery through the use of surface electromyography and a motion capture data glove. Surg. Endosc. 28, 1314–1320 (2014)CrossRefGoogle Scholar
- 13.Pérez-Duarte, F.J., Sánchez-Margallo, F.M., Martín-Portugués, I.D.-G., Sánchez-Hurtado, M.A., Lucas-Hernández, M., Sánchez-Margallo, J.A., et al.: Ergonomic analysis of muscle activity in the forearm and back muscles during laparoscopic surgery. Surg. Laparosc. Endosc. Percutan. Tech. 23, 203–207 (2013)CrossRefGoogle Scholar
- 16.Sánchez-Margallo, F.M., Sánchez-Margallo, J.A.: Use of a novel robotic laparoscopic instrument with ergonomic design for urethrovesical anastomosis: analysis of muscular activity and posture. International Congress of the European Association for Endoscopic Surgery, Bucharest, Romania (2015)Google Scholar
- 17.Hermens, H.J., Freriks, B., Merletti, R., Stegeman, D., Blok, J., Rau, G., et al.: SENIAM 8: European recommendation for surface electromyography. Roessingh Research and Development, Enschede (1999)Google Scholar
- 19.Pérez-Lanzac, A., Rosety, J., Okhunov, Z., Soto, J., Garcia-Baquero, R., Ledo, M.J. et al.: Robot-assisted laparoendoscopic hybrid single-site radical prostatectomy: a novel technique using Kymerax. J. Endourol. 27, Part B, Videourology (2013)Google Scholar
- 20.Nikolov, M., Mekoula, S.T., Hauser, S., Planz, B.: First results comparing between hand-held robotic assisted prostatectomy and conventional radical endoscopic extraperitoneal prostatectomy (Kymerax, Terumo). 25th World Congress on Videourology. Sofia, Bulgaria (2014)Google Scholar