Adoption of ergonomic practices among robotic surgeons: a survey from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Ergonomics Task Force.

BACKGROUND

Robotic surgery has been postulated to offer ergonomic benefits, but there is limited research to support this. While ergonomic best practices have been published, adoption among surgeons is also unknown. We aimed to characterize ergonomic experiences and practices of robotic surgeons to identify potential opportunities for optimization.

METHODS

A web-based survey study of self-identified robotic surgeons was conducted, focusing on practice patterns, ergonomic preparation and support, and demographics. Select questions referred to frequency of pain after operating, of achieving best practices, and of supportive ergonomic equipment (5-point Likert). Using a dichotomized outcome of pain, associations with surgeon sex, height, and hand size were evaluated using multivariable logistic regression.

RESULTS

Among 292 surgeons, the median age was 42 years, and 63% were male. The median height was 68 inches, and median glove size was 7.0. A variety of surgical specialties and subspecialties were represented. 92% used an Intuitive DaVinci Xi platform (3% X, 1% DV5, 0.3% Si, 0.7% SP, 1% CMR Versius, 0.7% Medtronic Hugo). Overall, 41% reported frequent pain. Back pain (24%) and neck pain (19%) were most common. Yet, most surgeons reported following most of the ergonomic best practices. In multivariable analysis, female surgeons had higher odds of pain after operating, controlling for height and glove size (adjusted odds ratio: 2.34, 95% CI 1.01-5.49, p = 0.049). Supportive equipment including ergonomic console chairs were not frequently available.

CONCLUSIONS

There was a high prevalence of pain among robotic surgeons, especially female surgeons, despite high rates of reported adoption of ergonomic best practices. These data suggest that robotic platforms alone are not sufficient, and there exists an unmet need to improve ergonomics among robotic surgeons. Future efforts to elucidate underlying reasons, objectively measure surgeon ergonomics, and develop and test new interventions are needed.