1. Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: A Pilot Study
- Author
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Jacqueline A. Cunkelman, Benjamin Nutter, Kimberly Kenton, Sam J. Brancato, Megan E. Tarr, and Anthony Polcari
- Subjects
Male ,medicine.medical_specialty ,Posture ,Pilot Projects ,Workload ,Wrist ,Gynecologic Surgical Procedures ,Blood loss ,Musculoskeletal Pain ,Interquartile range ,Surveys and Questionnaires ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Man-Machine Systems ,Aged ,Surgeons ,business.industry ,Obstetrics and Gynecology ,Human factors and ergonomics ,Robotics ,Middle Aged ,United States ,Surgery ,Occupational Diseases ,medicine.anatomical_structure ,Physical therapy ,Female ,Laparoscopy ,Body region ,Ergonomics ,Ankle ,business ,Body mass index - Abstract
Study Objective To compare resident, fellow, and attending urologic and gynecologic surgeons' musculoskeletal and mental strain during laparoscopic and robotic sacrocolpopexy. Design Prospective cohort study (Canadian Task Force classification II-2). Setting Academic medical center. Patients Patients who underwent robotic or laparoscopic sacrocolpopexy from October 2009 to January 2011. Interventions The Body Part Discomfort (BPD) survey was completed before cases, and the National Aeronautics and Space Administration Task Load Index and BPD survey were completed after cases. Higher scores on BPD and the National Aeronautics and Space Administration Task Load Index indicate greater musculoskeletal discomfort and mental strain. BPD scores were averaged over the following body regions: head/neck, back, hand/wrist, arms, and knees/ankles/feet. Changes in body region–specific discomfort scores were the primary outcomes. Measurements and Main Results Multivariable analysis was performed using mixed-effects linear regression with surgeon as a random effect. Sixteen surgeons participated (53% fellows, 34% residents, and 13% attendings). Thirty-three robotic and 53 laparoscopic cases were analyzed, with a median surgical time of 231 minutes (interquartile range, 204–293 minutes) versus 227 minutes (interquartile range, 203–272 minutes; p = .31), a median estimated blood loss of 100 mL (interquartile range, 50–175 mL) versus 150 mL (interquartile range, 50–200 mL; p = .22), and a mean patient body mass index of 27 ± 4 versus 26 ± 4 kg/m 2 (p = .26), respectively. Robotic surgeries were associated with lower neck/shoulder (−0.19 [interquartile range, −0.32 to −0.01], T = −2.49) and back discomfort scores (−0.35 [interquartile range, −0.58 to 0], T = −2.38) than laparoscopic surgeries. Knee/ankle/foot and arm discomfort increased with case length (0.18 [interquartile range, 0.02–0.3], T = 2.81) and (0.07 [interquartile range, 0.01–0.14], p = .03), respectively. Conclusion Surgeons performing minimally invasive sacrocolpopexy experienced less neck, shoulder, and back discomfort when surgery was performed robotically.
- Published
- 2015