Advertisement

Surgical Endoscopy

, Volume 32, Issue 5, pp 2533–2540 | Cite as

Validation of ergonomic instructions in robot-assisted surgery simulator training

  • C. D. P. Van’t Hullenaar
  • A. C. Mertens
  • J. P. Ruurda
  • I. A. M. J. Broeders
Article

Abstract

Background/Aim

Training in robot-assisted surgery focusses mainly on technical skills and instrument use. Training in optimal ergonomics during robotic surgery is often lacking, while improved ergonomics can be one of the key advantages of robot-assisted surgery. Therefore, the aim of this study was to assess whether a brief explanation on ergonomics of the console can improve body posture and performance.

Methods

A comparative study was performed with 26 surgical interns and residents using the da Vinci skills simulator (Intuitive Surgical, Sunnyvale, CA). The intervention group received a compact instruction on ergonomic settings and coaching on clutch usage, while the control group received standard instructions for usage of the system. Participants performed two sets of five exercises. Analysis was performed on ergonomic score (RULA) and performance scores provided by the simulator. Mental and physical load scores (NASA-TLX and LED score) were also registered.

Results

The intervention group performed better in the clutch-oriented exercises, displaying less unnecessary movement and smaller deviation from the neutral position of the hands. The intervention group also scored significantly better on the RULA ergonomic score in both the exercises. No differences in overall performance scores and subjective scores were detected.

Conclusion

The benefits of a brief instruction on ergonomics for novices are clear in this study. A single session of coaching and instruction leads to better ergonomic scores. The control group showed often inadequate ergonomic scores. No significant differences were found regarding physical discomfort, mental task load and overall performance scores.

Keywords

Robot Ergonomics Training Minimally invasive surgery 

Notes

Acknowledgements

Many thanks to the residents and interns at the Department of Surgery for their cooperation in this research project.

Compliance with ethical standards

Disclosures

Broeders is a Proctor at Intuitive Surgery. Van’t Hullenaar, Mertens, and Ruurda have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5959_MOESM1_ESM.docx (323 kb)
Supplementary material 1 (DOCX 323 KB)
464_2017_5959_MOESM2_ESM.docx (17 kb)
Supplementary material 2 (DOCX 16 KB)
464_2017_5959_MOESM3_ESM.jpg (298 kb)
Supplementary material 3 (JPG 298 KB)
464_2017_5959_MOESM4_ESM.jpg (88 kb)
Supplementary material 4 (JPG 88 KB)
464_2017_5959_MOESM5_ESM.jpg (77 kb)
Supplementary material 5 (JPG 76 KB)
464_2017_5959_MOESM6_ESM.docx (21 kb)
Supplementary material 6 (DOCX 20 KB)

References

  1. 1.
    Broeders IAMJ (2014) Robotics: the next step?. Best Pract Res Clin Gastroenterol 28(1):225–232CrossRefPubMedGoogle Scholar
  2. 2.
    Raza SJ, Froghi S, Chowriappa A, Ahmed K, Field E, Stegemann AP et al (2014) Construct validation of the key components of fundamental skills of robotic surgery (FSRS) curriculum: a multi-institution prospective study. J Surg Educ 71(3):316–324CrossRefPubMedGoogle Scholar
  3. 3.
    Sealed Envelope Ltd. Create a blocked randomisation list [Internet]. 2016 [cited 2016 Apr 5]. https://www.sealedenvelope.com/simple-randomiser/v1/lists
  4. 4.
    Yang K, Perez M, Perrenot C, Hubert N, Felblinger J, Hubert J (2016) A new system for evaluation of armrest use in robotic surgery and validation of a new ergonomic concept: armrest load. Int J Med Robot Comput Assist Surg 12:604–612CrossRefGoogle Scholar
  5. 5.
    Mcatamney L, Corlett EN (1993) RULA: a survey method for the investigation of world-related upper limb disorders. Appl Ergon 24(2):91–99CrossRefPubMedGoogle Scholar
  6. 6.
    Corlett EN, Bishop RP (1976) A technique for assessing postural discomfort. Ergonomics 19(2):175–182CrossRefPubMedGoogle Scholar
  7. 7.
    Hart SG (2006) NASA-task load index (NASA-TLX); 20 years later. Hum Factors Ergon Soc Annu Meet 50:904–908CrossRefGoogle Scholar
  8. 8.
    Rubio S, Diaz E, Martin J, Puente J (2004) Evaluation of subjective mental workload: a comparison of SWAT, NASA-TLX, and workload profile methods. Appl Psychol 53:61–86CrossRefGoogle Scholar
  9. 9.
    Van Der Schatte Olivier RH, Van’t Hullenaar CDP, Ruurda JP, Broeders IAMJ (2009) Ergonomics, user comfort, and performance in standard and robot-assisted laparoscopic surgery. Surg Endosc 23(6):1365–1371CrossRefGoogle Scholar
  10. 10.
    Mohammad Mirbod S, Yoshida H, Miyamoto K, Miyashita K, Inaba R, Iwata H (1995) Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health 67(3):179–186Google Scholar
  11. 11.
    Sari V, Nieboer TE, Vierhout ME, Stegeman DF, Kluivers KB (2010) The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minim Invasive Ther Allied Technol 19(2):105–109CrossRefPubMedGoogle Scholar
  12. 12.
    Auerbach JD, Weidner ZD, Milby AH, Diab M, Lonner BS (2011) Musculoskeletal disorders among spine surgeons: results of a survey of the Scoliosis Research Society membership. Spine 36(26):E1715–1721CrossRefPubMedGoogle Scholar
  13. 13.
    Dalager T, Søgaard K, Jensen PT (2016) Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review. Surg Endosc 31:516–526CrossRefPubMedGoogle Scholar
  14. 14.
    Tzeng Y-S, Chen S-G, Chen T-M (2012) Herniation of the cervical disk in plastic surgeons. Ann Plast Surg 69(6):672–674CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • C. D. P. Van’t Hullenaar
    • 1
  • A. C. Mertens
    • 1
    • 2
  • J. P. Ruurda
    • 2
  • I. A. M. J. Broeders
    • 1
  1. 1.Department of SurgeryMeander Medical CenterAmersfoortThe Netherlands
  2. 2.Department of SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands

Personalised recommendations