Cooper Hedda, Lau Hiu Ming, Mohan Helen
St Vincent's Hospital Melbourne, Victoria, Australia.
Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
J Robot Surg. 2025 May 31;19(1):252. doi: 10.1007/s11701-025-02401-6.
Robotic-assisted laparoscopic surgery has become more common in recent years with multiple benefits to patients. However, it poses musculoskeletal risks to surgeons, and given their long careers, it is vital to prolong surgeons' longevity. This review aims to evaluate ergonomic impact and methods of ergonomic assessment in surgeons performing traditional and robotic-assisted laparoscopic surgery. To evaluate the ergonomics and how different body areas were being affected by robotic and laparoscopic surgeons, we performed a systematic review of studies following PRISMA guidelines and focussing on muscular and ergonomic assessment of laparoscopic surgeons. Electronic Ovid Medline and Embase databases were searched on the 15th of June 2023. 16 studies were identified, involving 508 surgeons. 530 traditional laparoscopies and 535 robotic-assisted laparoscopies were included. Mixed methods, including surface electromyography (sEMG) and Borg CR10 physical exertion scale, were used to assess muscular activation and fatigue. Whilst individual studies produced conflicting results, overall sEMG and BORG CR10 scales showed that in TLS the deltoid, triceps, biceps and wrist muscles are most commonly activated. In addition, in RALs, lower back, trapezius and finger muscles were activated most commonly. Muscle activations as a whole were generally lower in robotic-assisted laparoscopy. Survey tools such as NASA-TLX confirmed that overall RALS was less fatiguing than TLS for the majority of surgeons. This review explored the ergonomic risks faced by surgeons performing both traditional laparoscopic and robotic surgery. Further research, including standardised methodology and continuous ergonomic assessment, are warranted to ensure robotic surgery remains safe.
近年来，机器人辅助腹腔镜手术变得越来越普遍，给患者带来了诸多益处。然而，它给外科医生带来了肌肉骨骼方面的风险，鉴于他们的职业生涯漫长，延长外科医生的职业寿命至关重要。本综述旨在评估进行传统和机器人辅助腹腔镜手术的外科医生的人体工程学影响及人体工程学评估方法。为了评估人体工程学以及机器人手术和腹腔镜手术对外科医生不同身体部位的影响，我们按照PRISMA指南对相关研究进行了系统综述，重点关注腹腔镜外科医生的肌肉和人体工程学评估。2023年6月15日检索了电子Ovid Medline和Embase数据库。共识别出16项研究，涉及508名外科医生。纳入了530例传统腹腔镜手术和535例机器人辅助腹腔镜手术。采用包括表面肌电图（sEMG）和Borg CR10体力劳动量表在内的混合方法来评估肌肉激活和疲劳程度。虽然个别研究结果相互矛盾，但总体而言，sEMG和BORG CR10量表显示，在传统腹腔镜手术中，三角肌、肱三头肌、肱二头肌和腕部肌肉最常被激活。此外，在机器人辅助腹腔镜手术中，下背部、斜方肌和手指肌肉最常被激活。总体而言，机器人辅助腹腔镜手术中的肌肉激活程度通常较低。美国国家航空航天局任务负荷指数（NASA-TLX）等调查工具证实，对于大多数外科医生来说，机器人辅助腹腔镜手术总体上比传统腹腔镜手术更不易疲劳。本综述探讨了进行传统腹腔镜手术和机器人手术的外科医生所面临的人体工程学风险。有必要进行进一步研究，包括标准化方法和持续的人体工程学评估，以确保机器人手术的安全性。
