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Robotic Colon and Rectal Surgery pp 169–182Cite as

Ergonomics in Robotic Colorectal Surgery

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Abstract

Improved ergonomic conditions for the operating surgeon are proposed as a cornerstone advantage of the robotic surgical platform. When conceptually applied to colorectal surgery and in particular rectal dissection, the ergonomic advantages of the robotic surgeon console over traditional laparoscopic or open pelvic dissection are almost irrefutable. Sitting at the console with the advantages of magnified three-dimensional vision, surgeon-controlled camera movement, and articulating tremor damping wristed instruments, a vast improvement is apparent over the back-bending-arm-wrenching-torque-creating callisthenic that is required in laparoscopy and open rectal surgery. The trade-off for this improved working environment is both the loss of haptic feedback and the yet to be accurately quantified cost of the platform in comparison to open or laparoscopic surgery.

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References

  1. Park A, Lee G, Seagull FJ, Meenaghan N, Dexter D. Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg. 2010;210(3):306–13.

    Article  PubMed  Google Scholar 

  2. Franasiak J, Ko EM, Kidd J, Secord AA, Bell M, Boggess JF, et al. Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol. 2012;126(3):437–42.

    Article  PubMed  Google Scholar 

  3. Berguer R, Forkey DL, Smith WD. Ergonomic problems associated with laparoscopic surgery. Surg Endosc. 1999;13(5):466–8.

    Article  CAS  PubMed  Google Scholar 

  4. Wauben LS, van Veelen MA, Gossot D, Goossens RH. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons. Surg Endosc. 2006;20(8):1268–74.

    Article  CAS  PubMed  Google Scholar 

  5. Szeto GP, Ho P, Ting AC, Poon JT, Cheng SW, Tsang RC. Work-related musculoskeletal symptoms in surgeons. J Occup Rehabil. 2009;19(2):175–84.

    Article  PubMed  Google Scholar 

  6. Berguer R. Surgery and ergonomics. Arch Surg. 1999;134(9):1011–6.

    Article  CAS  PubMed  Google Scholar 

  7. Stylopoulos N, Rattner D. Robotics and ergonomics. Surg Clin North Am. 2003;83(6):1321–37.

    Article  PubMed  Google Scholar 

  8. Lee G, Lee T, Dexter D, Klein R, Park A. Methodological infrastructure in surgical ergonomics: a review of tasks, models, and measurement systems. Surg Innov. 2007;14(3):153–67.

    Article  PubMed  Google Scholar 

  9. Tompa E, Dolinschi R, de Oliveira C, Irvin E. A systematic review of occupational health and safety interventions with economic analyses. J Occup Environ Med. 2009;51(9):1004–23.

    Article  PubMed  Google Scholar 

  10. Fb G. Motion study in surgery. Can J Med Surg. 1916;40:22–31.

    Google Scholar 

  11. Mirbod SM, Yoshida H, Miyamoto K, Miyashita K, Inaba R, Iwata H. Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health. 1995;67(3):179–86.

    CAS  PubMed  Google Scholar 

  12. Patkin M. Ergonomic aspects of surgical dexterity. Med J Aust. 1967;2(17):775–7.

    CAS  PubMed  Google Scholar 

  13. Brearley S, Watson H. Towards an efficient retractor handle: an ergonomic study. Ann R Coll Surg Engl. 1983;65(6):382–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Galassini A. Lighting system for operating-rooms—criteria and norms. Elettrotecnica. 1990;77(12):1153–8.

    Google Scholar 

  15. Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, et al. Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg. 2007;193(4):519–22.

    Article  PubMed  Google Scholar 

  16. Berguer R, Smith WD, Chung YH. Performing laparoscopic surgery is significantly more stressful for the surgeon than open surgery. Surg Endosc. 2001;15(10):1204–7.

    Article  CAS  PubMed  Google Scholar 

  17. Tendik F, Jennings RW, Tharp G, Stark L. Sensing and manipulation problems in endoscopic surgery: experiment, analysis, and observations. Presence. 1993;2:66–80.

    Article  Google Scholar 

  18. Birkett DH, Josephs LG, Este-McDonald J. A new 3-D laparoscope in gastrointestinal surgery. Surg Endosc. 1994;8(12):1448–51.

    Article  CAS  PubMed  Google Scholar 

  19. Crosthwaite G, Chung T, Dunkley P, Shimi S, Cuschieri A. Comparison of direct vision and electronic two- and three-dimensional display systems on surgical task efficiency in endoscopic surgery. Br J Surg. 1995;82(6):849–51.

    Article  CAS  PubMed  Google Scholar 

  20. Durrani AF, Preminger GM. Three-dimensional video imaging for endoscopic surgery. Comput Biol Med. 1995;25(2):237–47.

    Article  CAS  PubMed  Google Scholar 

  21. Jones DB, Brewer JD, Soper NJ. The influence of three-dimensional video systems on laparoscopic task performance. Surg Laparosc Endosc. 1996;6(3):191–7.

    Article  CAS  PubMed  Google Scholar 

  22. Chan AC, Chung SC, Yim AP, Lau JY, Ng EK, Li AK. Comparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery. Surg Endosc. 1997;11(5):438–40.

    Article  CAS  PubMed  Google Scholar 

  23. Hanna GB, Shimi SM, Cuschieri A. Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet. 1998;351(9098):248–51.

    Article  CAS  PubMed  Google Scholar 

  24. Kavoussi LR, Moore RG, Adams JB, Partin AW. Comparison of robotic versus human laparoscopic camera control. J Urol. 1995;154(6):2134–6.

    Article  CAS  PubMed  Google Scholar 

  25. Kroh W, Chalikonda S, editors. Essentials of robotic surgery. New York: Springer; 2015.

    Google Scholar 

  26. Marcus M, Gerr F. Upper extremity musculoskeletal symptoms among female office workers: associations with video display terminal use and occupational psychosocial stressors. Am J Ind Med. 1996;29(2):161–70.

    Article  CAS  PubMed  Google Scholar 

  27. Travers PH, Stanton BA. Office workers and video display terminals: physical, psychological and ergonomic factors. AAOHN J. 2002;50(11):489–93.

    PubMed  Google Scholar 

  28. Arndt R. Working posture and musculoskeletal problems of video display terminal operators—review and reappraisal. Am Ind Hyg Assoc J. 1983;44(6):437–46.

    Article  CAS  PubMed  Google Scholar 

  29. Hanna GB, Shimi SM, Cuschieri A. Task performance in endoscopic surgery is influenced by location of the image display. Ann Surg. 1998;227(4):481-4. PMCID: 1191300.

    Google Scholar 

  30. Matern U, Faist M, Kehl K, Giebmeyer C, Buess G. Monitor position in laparoscopic surgery. Surg Endosc. 2005;19(3):436–40.

    Article  CAS  PubMed  Google Scholar 

  31. Szeto GP, Cheng SW, Poon JT, Ting AC, Tsang RC, Ho P. Surgeons’ static posture and movement repetitions in open and laparoscopic surgery. J Surg Res. 2012;172(1):e19–31.

    Article  PubMed  Google Scholar 

  32. Albayrak A, van Veelen MA, Prins JF, Snijders CJ, de Ridder H, Kazemier G. A newly designed ergonomic body support for surgeons. Surg Endosc. 2007;21(10):1835–40.

    Article  CAS  PubMed  Google Scholar 

  33. Nguyen NT, Ho HS, Smith WD, Philipps C, Lewis C, De Vera RM, et al. An ergonomic evaluation of surgeons’ axial skeletal and upper extremity movements during laparoscopic and open surgery. Am J Surg. 2001;182(6):720–4.

    Article  CAS  PubMed  Google Scholar 

  34. Berguer R, Rab GT, Abu-Ghaida H, Alarcon A, Chung J. A comparison of surgeons’ posture during laparoscopic and open surgical procedures. Surg Endosc. 1997;11(2):139–42.

    Article  CAS  PubMed  Google Scholar 

  35. Bos E, Krol B, van der Star L, Groothoff J. Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists. Int Arch Occup Environ Health. 2007;80(3):198–206.

    Article  PubMed  Google Scholar 

  36. Hayes M, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg. 2009;7(3):159–65.

    Article  PubMed  Google Scholar 

  37. Kant IJ, de Jong LC, van Rijssen-Moll M, Borm PJ. A survey of static and dynamic work postures of operating room staff. Int Arch Occup Environ Health. 1992;63(6):423–8.

    Article  CAS  PubMed  Google Scholar 

  38. Szeto GP, Ho P, Ting AC, Poon JT, Tsang RC, Cheng SW. A study of surgeons’ postural muscle activity during open, laparoscopic, and endovascular surgery. Surg Endosc. 2010;24(7):1712–21.

    Article  CAS  PubMed  Google Scholar 

  39. Albayrak K, Meijer B. Current state of ergonomics of operating rooms of Dutch hospitals in the endoscopic era. Minim Invasive Ther Allied Technol. 2004;13(3):156–60.

    Article  CAS  PubMed  Google Scholar 

  40. Berguer R, Smith WD, Davis S. An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc. 2002;16(3):416–21.

    Article  Google Scholar 

  41. van Veelen MA, Kazemier G, Koopman J, Goossens RH, Meijer DW. Assessment of the ergonomically optimal operating surface height for laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2002;12(1):47–52.

    Article  PubMed  Google Scholar 

  42. Lee GI, Lee MR, Clanton T, Sutton E, Park AE, Marohn MR. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries. Surg Endosc. 2014;28(2):456–65.

    Article  PubMed  Google Scholar 

  43. Szeto GP, Straker LM, O’Sullivan PB. A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work--1: neck and shoulder muscle recruitment patterns. Man Ther. 2005;10(4):270–80.

    Article  PubMed  Google Scholar 

  44. Szeto GP, Straker LM, O’Sullivan PB. EMG median frequency changes in the neck-shoulder stabilizers of symptomatic office workers when challenged by different physical stressors. J Electromyogr Kinesiol. 2005;15(6):544–55.

    Article  PubMed  Google Scholar 

  45. Edmonson JM. History of the instruments for gastrointestinal endoscopy. Gastrointest Endosc. 1991;37(2 Suppl):S27–56.

    Article  CAS  PubMed  Google Scholar 

  46. Elhage O, Challacombe B, Murphy D, Khan MS, Dasgupta P. The evolution and ergonomics of robotic-assisted surgical systems. In: Kommu S, editor. Rehabilitation robotics. Vienna: Itech Education; 2007. p. 81–90.

    Google Scholar 

  47. Gupta V, Reddy NP, Batur P. Forces in laparoscopic surgical tools. Presence Teleop Virt. 1997;6(2):218–28.

    Article  Google Scholar 

  48. Sukthankar SM, Reddy NP. Force feedback issues in minimally invasive surgery. In: Satava RM, Morgan K, Seeburg HB, editors. Proceedings of the interactive technology and the new paradigm for the healthcare. Amsterdam: IOS Press; 1995. p. 375–9.

    Google Scholar 

  49. Majeed AW, Jacob G, Reed MW, Johnson AG. Laparoscopist’s thumb: an occupational hazard. Arch Surg. 1993;128(3):357.

    Article  CAS  PubMed  Google Scholar 

  50. Patkin M, Isabel L. Ergonomics, engineering and surgery of endosurgical dissection. J R Coll Surg Edinb. 1995;40(2):120–32.

    CAS  PubMed  Google Scholar 

  51. Elhage O, Murphy D, Challacombe B, Shortland A, Dasgupta P. Ergonomics in minimally invasive surgery. Int J Clin Pract. 2007;61(2):186–8.

    Article  CAS  PubMed  Google Scholar 

  52. Sturges RH. A quantification of machine dexterity applied to an assembly task. Int J Robot Res. 1990;9(3):49–62.

    Article  Google Scholar 

  53. Yang Y, Wang F, Zhang P, Shi C, Zou Y, Qin H, et al. Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol. 2012;19(12):3727–36.

    Article  PubMed  Google Scholar 

  54. Sackier JM, Berci G. A laparoscopic hazard for the surgeon. Br J Surg. 1992;79(7):713.

    Article  CAS  PubMed  Google Scholar 

  55. Lee G, Lee T, Dexter D, Godinez C, Meenaghan N, Catania R, et al. Ergonomic risk associated with assisting in minimally invasive surgery. Surg Endosc. 2009;23(1):182–8.

    Article  PubMed  Google Scholar 

  56. Wexner SD, Bergamaschi R, Lacy A, Udo J, Brolmann H, Kennedy RH, et al. The current status of robotic pelvic surgery: results of a multinational interdisciplinary consensus conference. Surg Endosc. 2009;23(2):438–43.

    Article  PubMed  Google Scholar 

  57. Pigazzi A, Garcia-Aguilar J. Robotic colorectal surgery: for whom and for what? Dis Colon Rectum. 2010;53(7):969–70.

    Article  PubMed  Google Scholar 

  58. Sng KK, Hara M, Shin JW, Yoo BE, Yang KS, Kim SH. The multiphasic learning curve for robot-assisted rectal surgery. Surg Endosc. 2013;27(9):3297–307.

    Article  PubMed  Google Scholar 

  59. Alarcon A, Berguer R. A comparison of operating room crowding between open and laparoscopic operations. Surg Endosc. 1996;10(9):916–9.

    Article  CAS  PubMed  Google Scholar 

  60. Cuschieri A. Whither minimal access surgery: tribulations and expectations. Am J Surg. 1995;169(1):9–19.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    John G. Armstrong M.D. & John C. Byrn M.D.

Authors
  1. John G. Armstrong M.D.
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  2. John C. Byrn M.D.
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Correspondence to John G. Armstrong M.D. .

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Editors and Affiliations

  1. Department of Surger Division of Colon and Rectal Surgery, George Washington University, Washington, DC, District of Columbia, USA

    Vincent Obias

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Armstrong, J.G., Byrn, J.C. (2017). Ergonomics in Robotic Colorectal Surgery. In: Obias, V. (eds) Robotic Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43256-4_13

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  • DOI: https://doi.org/10.1007/978-3-319-43256-4_13

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