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Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries

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An Erratum to this article was published on 10 January 2015

Abstract

Background

We conducted this study to investigate how physical and cognitive ergonomic workloads would differ between robotic and laparoscopic surgeries and whether any ergonomic differences would be related to surgeons’ robotic surgery skill level. Our hypothesis is that the unique features in robotic surgery will demonstrate skill-related results both in substantially less physical and cognitive workload and uncompromised task performance.

Methods

Thirteen MIS surgeons were recruited for this institutional review board-approved study and divided into three groups based on their robotic surgery experiences: laparoscopy experts with no robotic experience, novices with no or little robotic experience, and robotic experts. Each participant performed six surgical training tasks using traditional laparoscopy and robotic surgery. Physical workload was assessed by using surface electromyography from eight muscles (biceps, triceps, deltoid, trapezius, flexor carpi ulnaris, extensor digitorum, thenar compartment, and erector spinae). Mental workload assessment was conducted using the NASA-TLX.

Results

The cumulative muscular workload (CMW) from the biceps and the flexor carpi ulnaris with robotic surgery was significantly lower than with laparoscopy (p < 0.05). Interestingly, the CMW from the trapezius was significantly higher with robotic surgery than with laparoscopy (p < 0.05), but this difference was only observed in laparoscopic experts (LEs) and robotic surgery novices. NASA-TLX analysis showed that both robotic surgery novices and experts expressed lower global workloads with robotic surgery than with laparoscopy, whereas LEs showed higher global workload with robotic surgery (p > 0.05). Robotic surgery experts and novices had significantly higher performance scores with robotic surgery than with laparoscopy (p < 0.05).

Conclusions

This study demonstrated that the physical and cognitive ergonomics with robotic surgery were significantly less challenging. Additionally, several ergonomic components were skill-related. Robotic experts could benefit the most from the ergonomic advantages in robotic surgery. These results emphasize the need for well-structured training and well-defined ergonomics guidelines to maximize the benefits utilizing the robotic surgery.

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Acknowledgments

This study was supported by a clinical robotics research Grant from the 2012 Intuitive Surgical, Inc. The authors acknowledge the thoughtful and careful assistance of Elizabeth Cockey and Valerie K. Scott in editing the manuscript.

Disclosures

Dr. Gyusung Lee received 2012 Intuitive Surgical Robotic Clinical Research Grant as the Principle Investigator of this study. Drs. Mija Lee, Erica Sutton, Adrian Park, and Michael Marohn and Mrs. Tameka Clanton have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock Building, Room 1210, Baltimore, MD, 21287, USA

    Gyusung I. Lee, Mija R. Lee & Michael R. Marohn

  2. Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Tamera Clanton

  3. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA

    Erica Sutton

  4. Department of Surgery, Anne Arundel Medical Center, Annapolis, MD, USA

    Adrian E. Park

Authors
  1. Gyusung I. Lee
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  2. Mija R. Lee
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  3. Tamera Clanton
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  4. Erica Sutton
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  5. Adrian E. Park
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  6. Michael R. Marohn
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Corresponding author

Correspondence to Gyusung I. Lee.

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Lee, G.I., Lee, M.R., Clanton, T. et al. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries. Surg Endosc 28, 456–465 (2014). https://doi.org/10.1007/s00464-013-3213-z

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  • DOI: https://doi.org/10.1007/s00464-013-3213-z

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