Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia.
Department of General Surgery, Prince of Wales Hospital, Sydney, NSW, Australia.
J Robot Surg. 2024 May 27;18(1):224. doi: 10.1007/s11701-024-01992-w.
There is a high prevalence of upper limb musculoskeletal pain among robotic surgeons. Poor upper limb ergonomic positioning during robotic surgery occurs when the shoulders are abducted, and the elbows are lifted off the console armrest. The validated rapid upper limb assessment can quantify ergonomic efficacy. Surface electromyography and hand dynamometer assessment of strength are the most common methods to assess muscle fatigue. A literature review was performed to find evidence of ergonomic interventions which reduce upper limb musculoskeletal pain during robotic surgery. There is a paucity of studies which have reported on this topic. In other occupations, there is strong evidence for the use of resistance training to prevent upper extremity pain. Use of forearm compression sleeves, stretching, and massage may help reduce forearm fatigue. Microbreaks with targeted stretching, active ergonomic training, improved use of armrest, and optimal hand controller design have been shown to reduce upper limb musculoskeletal pain. Future studies should assess which interventions are beneficial in reducing surgeon upper limb pain during robotic surgery.
机器人手术医生上肢肌肉骨骼疼痛的发病率很高。当肩部外展和肘部离开控制台扶手时，机器人手术中上肢的人体工程学位置不佳。经过验证的快速上肢评估可以量化人体工程学效果。表面肌电图和握力计评估力量是评估肌肉疲劳最常用的方法。进行了文献回顾，以寻找减少机器人手术中上肢肌肉骨骼疼痛的人体工程学干预措施的证据。关于这个主题的研究很少。在其他职业中，有强有力的证据表明使用阻力训练来预防上肢疼痛。使用前臂压缩袖套、伸展和按摩可能有助于减少前臂疲劳。微休息与有针对性的伸展、主动人体工程学训练、更好地使用扶手和优化手控制器设计已被证明可以减轻上肢肌肉骨骼疼痛。未来的研究应该评估哪些干预措施有助于减少机器人手术中外科医生的上肢疼痛。
