Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA.
Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
Surg Endosc. 2023 Dec;37(12):9244-9254. doi: 10.1007/s00464-023-10485-0. Epub 2023 Oct 23.
We compared surgeons' workload, physical discomfort, and neuromusculoskeletal disorders (NMSDs) across four surgical modalities: endoscopic, laparoscopic, open, and robot-assisted (da Vinci Surgical Systems).
An electronic survey was sent to the surgeons across an academic hospital system. The survey consisted of 47 questions including: (I) Demographics and anthropometrics; (II) The percentage of the procedural time that the surgeon spent on performing each surgical modality; (III) Physical and mental demand and physical discomfort; (IV) Neuromusculoskeletal symptoms including body part pain and NMSDs.
Seventy-nine out of 245 surgeons completed the survey (32.2%) and 65 surgeons (82.2%) had a dominant surgical modality: 10 endoscopic, 15 laparoscopic, 26 open, and 14 robotic surgeons. Physical demand was the highest for open surgery and the lowest for endoscopic and robotic surgeries, (all p < 0.05). Open and robotic surgeries required the highest levels of mental workload followed by laparoscopic and endoscopic surgeries, respectively (all p < 0.05 except for the difference between robotic and laparoscopic that was not significant). Body part discomfort or pain (immediately after surgery) were lower in the shoulder for robotic surgeons compared to laparoscopic and open surgeons and in left fingers for robotic surgeons compared to endoscopic surgeons (all p < 0.05). The prevalence of NMSD was significantly lower in robotic surgeons (7%) compared to the other surgical modalities (between 60 and 67%) (all p < 0.05).
The distribution of NMSDs, workload, and physical discomfort varied significantly based on preferred surgical approach. Although robotic surgeons had fewer overall complaints, improvement in ergonomics of surgery are still warranted.
我们比较了内镜、腹腔镜、开放和机器人辅助（达芬奇手术系统）四种手术方式下外科医生的工作量、身体不适和肌肉骨骼疾病（MSD）。
我们向整个学术医院系统的外科医生发送了电子调查问卷。该调查问卷包括 47 个问题，包括：（一）人口统计学和人体测量学；（二）外科医生完成每种手术方式的手术时间比例；（三）体力和精神需求以及身体不适；（四）肌肉骨骼症状，包括身体部位疼痛和 MSD。
245 名外科医生中有 79 名（32.2%）完成了调查，65 名外科医生（82.2%）有主导的手术方式：10 名内镜、15 名腹腔镜、26 名开放和 14 名机器人外科医生。开放手术的体力需求最高，内镜和机器人手术的体力需求最低（均 P < 0.05）。开放和机器人手术需要最高水平的精神工作量，其次是腹腔镜和内镜手术（除了机器人和腹腔镜之间的差异不显著外，均 P < 0.05）。机器人外科医生的肩部和腹腔镜及开放外科医生相比，手部和左手指与内镜外科医生相比，身体不适或疼痛（术后即刻）明显较低（均 P < 0.05）。与其他手术方式（60%至 67%）相比，机器人外科医生的肌肉骨骼疾病患病率明显较低（7%）（均 P < 0.05）。
肌肉骨骼疾病、工作量和身体不适的分布根据首选手术方式有显著差异。尽管机器人外科医生总体投诉较少，但仍需要改善手术的人体工程学。
