Inadequacies exist in the ergonomics of upper body positioning of robotic surgeons; these deficits in biomechanical efficacy predispose surgeons to musculoskeletal injury. Ergonomics and biomechanics may be objectively measured using the Rapid Entire Body Assessment (REBA) and the Rapid Upper Limb Assessment (RULA) to quantify ergonomic efficacy. The purpose of this study is to use validated ergonomic tools to assess the posture of robotic surgeons to examine deficiencies. Four robotic surgeons using the da Vinci model were observed for a minimum of 30 min each. An Xbox connect camera was positioned 10 feet away from the surgeon console. Kinetisense software measured position of the head, shoulders, mid-spine, hips, and knees. One image was captured every 30 s. The software measured the positions in centimeters that deviated from an ideal central postural line (plumb line). RULA and REBA were also employed to assess posture using a still image at 15 min. The average RULA score for the four surgeons was 4.75 (range 3–6). The average REBA score for the four surgeons was 7 (range 5–8). The average RULA score of 4.5/7 and the average REBA of 7/15 qualify as medium risk with the recommendation that action is needed to improve ergonomics. While this pilot study is limited in size, it demonstrates the need for further investigation. With more than half of surgeons reporting musculoskeletal pain after robotic surgery (McDonald et al. in Gynecol Oncol 134:243–247, 2014), poor posture may offer an explanation.
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McDonald ME, Ramirez PT, Munsell MF, Greer M, Burke WM, Naumann WT, Frumovitz M (2014) Physician pain and discomfort during minimally invasive gynecologic cancer surgery. Gynecol Oncol 134(2):243–247
Wang DS (2017) Re: do no harm, except to ourselves? A survey of symptoms and injuries in oncologic surgeons and pilot study of an intraoperative ergonomic intervention. J Urol 198(4):721
Tierney J, Terhune K (2017) Expanding the National Health Service Corps Scholarship Program to general surgery: a proposal to address the national shortage of general surgeons in the United States. JAMA Surg 152(4):315–316
Are C, Stoddard H, Carpenter LA, O’Holleran B, Thompson JS (2017) Trends in the match rate and composition of candidates matching into categorical general surgery residency positions in the United States. Am J Surg 213(1):187–194
Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA (2005) Muscles: testing and function, with posture and pain (Kendall, muscles). Lippincott Williams & Wilkins, Philadelphia
Chubineh A (2004) Posture analysis methods in occupational ergonomics, vol 1383. Fanavaran Publication, Tehran, pp 2–50
McAtamney L, Corlett EN (1993) RULA: a survey method for the investigation of work-related upper limb disorders. Appl Ergon 24(2):91–99
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Dwyer, A., Huckleby, J., Kabbani, M. et al. Ergonomic assessment of robotic general surgeons: a pilot study. J Robotic Surg 14, 387–392 (2020). https://doi.org/10.1007/s11701-019-00996-1
- Human factors