Giberti Claudio, Gallo Fabrizio, Francini Luca, Signori Alessio, Testa Marco
Department of Surgery, Division of Urology, San Paolo Hospital, Savona.
Arch Ital Urol Androl. 2014 Jun 30;86(2):95-8. doi: 10.4081/aiua.2014.2.95.
Robotic surgical systems offer better workplace in order to relieve surgeons from prolonged physical efforts and improve their surgical outcomes. However, robotic surgery could produce musculoskeletal disorders due to the prolonged sitting position of the operator, the fixed position of the console viewer and the movements of the limbs. Until today, no one study has been reported concerning the association between robotics and musculoskeletal pain. The aim of this work was verify the prevalence of musculoskeletal disorders among Italian robotic surgeons.
Between July 2011 and April 2012 a modified Standardized Nordic Questionnaire was delivered to thirty-nine Italian robotic centres. Twentytwo surgeons (56%) returned the questionnaires but only seventeen questionnaires (43.5%) were evaluable.
Seven surgeons (41.2%) reported musculoskeletal disorders, by since their first use of the robot which significantly persisted during the daily surgical activity (P < 0.001). Regarding the body parts affected, musculoskeletal disorders were mainly reported in the cervical spine (29.4%) and in the upper limbs (23.5%). Six surgeons (35.3%) defined the robotic console as less comfortable or neither comfortable/uncomfortable with a negative influence on their surgical procedures.
In spite of some important limitations, our data showed musculoskeletal disorders due to posture discomfort with negative impact on daily surgical activity among robotic surgeons. These aspects could be due to the lack of ergonomic seat and to the fixed position of the console viewer which could have produced an inadequate spinal posture. The evaluation of these postural factors, in particular the development of an integrated and more ergonomic chair, could further improve the comfort feeling of the surgeon at the console and probably his surgical outcomes.
机器人手术系统提供了更好的工作环境，使外科医生从长时间的体力劳动中解脱出来，并改善他们的手术效果。然而，由于操作者长时间坐着、控制台显示器位置固定以及肢体动作，机器人手术可能会导致肌肉骨骼疾病。到目前为止，尚未有关于机器人技术与肌肉骨骼疼痛之间关联的研究报道。这项工作的目的是核实意大利机器人外科医生中肌肉骨骼疾病的患病率。
2011年7月至2012年4月期间，向39个意大利机器人手术中心发放了一份经过修改的标准化北欧问卷。22名外科医生（56%）返回了问卷，但只有17份问卷（43.5%）可用于评估。
7名外科医生（41.2%）报告自首次使用机器人以来出现了肌肉骨骼疾病，且在日常手术活动中明显持续存在（P<0.001）。关于受影响的身体部位，肌肉骨骼疾病主要报告在颈椎（29.4%）和上肢（23.5%）。6名外科医生（35.3%）认为机器人控制台不太舒适或既不舒适也不难受，对他们的手术操作有负面影响。
尽管存在一些重要局限性，但我们的数据显示，机器人外科医生因姿势不适而出现肌肉骨骼疾病，对日常手术活动有负面影响。这些方面可能是由于缺乏符合人体工程学的座椅以及控制台显示器位置固定，可能导致脊柱姿势不当。对这些姿势因素进行评估，特别是开发一种更符合人体工程学的一体化座椅，可能会进一步提高外科医生在控制台的舒适感，并可能改善其手术效果。
