Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Avenue, C-325, Aurora, CO, 80045, USA.
Department of Surgery, City of Hope National Medical Center, Duarte, CA, 91010, USA.
Surg Endosc. 2022 Jan;36(1):292-299. doi: 10.1007/s00464-020-08274-0. Epub 2021 Feb 1.
There is a paucity of prospective data related to surgeon ergonomics, which affects career longevity. Robotic surgical systems may mitigate pain and workload. We hypothesized that ergonomic outcomes would vary based on surgeon height and gender, and the relative benefit of robotic surgery would vary based on these demographics.
Surgeons received questionnaires to fill out immediately before and after surgery to enable calculation of pain scores and task load. Surgeons who were ≤ 66 inches tall were considered "short". Univariable and multivariable regression analyses were performed where appropriate using Stata-MP version 14.2 (StataCorp LLC, College Station, TX).
There were 124 questionnaires given to 20 surgeons; 97 (78%) were returned, and 12 (12%) laparoscopic operations were excluded, leaving 85 (69%) questionnaires for further analysis: 33 (38%) from short surgeons, and 24 (28%) from women, for 30 (35%) robotic and 55 (65%) open operations. There were 44/85 (52%) surgeons who reported worse pain after surgery. Overall pain scores (1.1 ± 2.6 vs 1.5 ± 2.6, p = 0.70) were similar for robotic and open operations. In multivariable analysis, greater surgeon pain scores were significantly associated with short surgeons (p < 0.001), male surgeons (p < 0.001), and long operative times (p = 0.03). Physical demand was lower for robot vs open operations (median 10 vs 13, p = 0.03). When short surgeons (p = 0.04) and male surgeons (p = 0.03) were examined as sub-groups, lower physical demand during robotic operations persisted, but was lost when only examining tall surgeons (p = 0.07) and female surgeons (p = 0.13).
Short surgeons and male surgeons reported significantly more pain after both open and robotic operations but had less physical demand when using the robotic system. Future work should focus on mitigation of surgeon height-related factors and seek to understand ergonomic gender differences beyond height.
目前有关外科医生工效学的前瞻性数据很少，而这会影响职业生涯的长短。机器人手术系统可能会减轻疼痛和工作量。我们假设手术医生的身高和性别会影响工效学结果，而机器人手术的相对益处会根据这些人口统计学因素而有所不同。
给手术医生发放问卷，要求他们在手术前后立即填写，以便计算疼痛评分和任务负荷。身高≤66 英寸的医生被认为是“矮个”。使用 Stata-MP 版本 14.2（StataCorp LLC，College Station，TX）进行适当的单变量和多变量回归分析。
共向 20 名外科医生发放了 124 份问卷，其中 97 份（78%）返回，12 份（12%）腹腔镜手术被排除，85 份（69%）问卷可进一步分析：其中 33 份（38%）来自矮个医生，24 份（28%）来自女性，30 例（35%）为机器人手术，55 例（65%）为开放手术。44/85（52%）的医生报告手术后疼痛更严重。机器人手术和开放手术的总体疼痛评分相似（1.1±2.6 与 1.5±2.6，p=0.70）。多变量分析显示，手术医生疼痛评分较高与矮个医生（p<0.001）、男性医生（p<0.001）和手术时间较长（p=0.03）显著相关。与开放手术相比，机器人手术的体力需求较低（中位数 10 对 13，p=0.03）。当分别检查矮个医生（p=0.04）和男性医生（p=0.03）亚组时，机器人手术期间的体力需求较低，但仅检查高个医生（p=0.07）和女性医生（p=0.13）时则不存在。
矮个医生和男性医生在接受开放和机器人手术后报告的疼痛明显更多，但使用机器人系统时体力需求较低。未来的工作应重点关注减轻与手术医生身高相关的因素，并寻求理解身高以外的工效学性别差异。
