Lee E C, Rafiq A, Merrell R, Ackerman R, Dennerlein J T
Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
Surg Endosc. 2005 Aug;19(8):1064-70. doi: 10.1007/s00464-004-8213-6. Epub 2005 May 26.
Minimally invasive surgical techniques expose surgeons to a variety of occupational hazards that may promote musculoskeletal disorders. Telerobotic systems for minimally invasive surgery may help to reduce these stressors. The objective of this study was to compare manual and telerobotic endoscopic surgery in terms of postural and mental stress.
Thirteen participants with no experience as primary surgeons in endoscopic surgery performed a set of simulated surgical tasks using two different techniques--a telerobotic master--slave system and a manual endoscopic surgery system. The tasks consisted of passing a soft spherical object through a series of parallel rings, suturing along a line 5-cm long, running a 32-in ribbon, and cannulation. The Job Strain Index (JSI) and Rapid Upper Limb Assessment (RULA) were used to quantify upper extremity exposure to postural and force risk factors. Task duration was quantified in seconds. A questionnaire provided measures of the participants' intuitiveness and mental stress.
The JSI and RULA scores for all four tasks were significantly lower for the telerobotic technique than for the manual one. Task duration was significantly longer for telerobotic than for manual tasks. Participants reported that the telerobotic technique was as intuitive as, and no more stressful than, the manual technique.
Given identical tasks, the time to completion is longer using the telerobotic technique than its manual counterpart. For the given simulated tasks in the laboratory setting, the better scores for the upper extremity postural analysis indicate that telerobotic surgery provides a more comfortable environment for the surgeon without any additional mental stress.
微创手术技术使外科医生面临各种职业危害，这些危害可能会引发肌肉骨骼疾病。用于微创手术的远程机器人系统可能有助于减少这些压力源。本研究的目的是比较手动和远程机器人内窥镜手术在姿势和精神压力方面的差异。
13名没有作为主刀医生进行内窥镜手术经验的参与者使用两种不同技术执行了一组模拟手术任务——一种远程机器人主从系统和一种手动内窥镜手术系统。任务包括将一个柔软的球形物体穿过一系列平行环、沿着一条5厘米长的线缝合、展开一条32英寸的带子以及插管。工作应变指数（JSI）和快速上肢评估（RULA）用于量化上肢暴露于姿势和力量风险因素的程度。任务持续时间以秒为单位进行量化。一份问卷提供了参与者直观感受和精神压力的测量数据。
远程机器人技术在所有四项任务中的JSI和RULA得分均显著低于手动技术。远程机器人任务的持续时间明显长于手动任务。参与者报告称，远程机器人技术与手动技术一样直观，且压力并不更大。
在任务相同的情况下，使用远程机器人技术完成任务的时间比手动技术更长。对于实验室环境中给定的模拟任务，上肢姿势分析的更好得分表明，远程机器人手术为外科医生提供了更舒适的环境，且不会带来任何额外的精神压力。
