Skip to main content
SpringerLink
Log in

Validation of ergonomic instructions in robot-assisted surgery simulator training

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Broeders IAMJ (2014) Robotics: the next step?. Best Pract Res Clin Gastroenterol 28(1):225–232

    Article  PubMed  Google Scholar 

  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):316–324

    Article  PubMed  Google Scholar 

  3. Sealed Envelope Ltd. Create a blocked randomisation list [Internet]. 2016 [cited 2016 Apr 5]. https://www.sealedenvelope.com/simple-randomiser/v1/lists

  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 12:604–612

    Article  CAS  Google Scholar 

  5. Mcatamney L, Corlett EN (1993) RULA: a survey method for the investigation of world-related upper limb disorders. Appl Ergon 24(2):91–99

    Article  CAS  PubMed  Google Scholar 

  6. Corlett EN, Bishop RP (1976) A technique for assessing postural discomfort. Ergonomics 19(2):175–182

    Article  CAS  PubMed  Google Scholar 

  7. Hart SG (2006) NASA-task load index (NASA-TLX); 20 years later. Hum Factors Ergon Soc Annu Meet 50:904–908

    Article  Google Scholar 

  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 53:61–86

    Article  Google Scholar 

  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):1365–1371

    Article  Google Scholar 

  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):179–186

    Google Scholar 

  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):105–109

    Article  PubMed  Google Scholar 

  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):E1715–1721

    Article  PubMed  Google Scholar 

  13. Dalager T, Søgaard K, Jensen PT (2016) Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review. Surg Endosc 31:516–526

    Article  PubMed  Google Scholar 

  14. Tzeng Y-S, Chen S-G, Chen T-M (2012) Herniation of the cervical disk in plastic surgeons. Ann Plast Surg 69(6):672–674

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

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

Author information

Authors and Affiliations

  1. Department of Surgery, Meander Medical Center, Maatweg 3, 3818 TZ, Amersfoort, The Netherlands

    C. D. P. Van’t Hullenaar, A. C. Mertens & I. A. M. J. Broeders

  2. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

    A. C. Mertens & J. P. Ruurda

Authors
  1. C. D. P. Van’t Hullenaar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. C. Mertens
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. P. Ruurda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. A. M. J. Broeders
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. D. P. Van’t Hullenaar.

Ethics declarations

Disclosures

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

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van’t Hullenaar, C.D.P., Mertens, A.C., Ruurda, J.P. et al. Validation of ergonomic instructions in robot-assisted surgery simulator training. Surg Endosc 32, 2533–2540 (2018). https://doi.org/10.1007/s00464-017-5959-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-017-5959-1

Keywords

Search

Navigation