Comparing Ergonomics of Robot-assisted and Laparoscopic procedures

• Research type

  Research Study

• Full title

  Comparing the musculoskeletal demands of surgeons performing Robotic-assisted Laparoscopic surgery and standard laparoscopic surgery

• IRAS ID

  279932

• Contact name

  Chris Gaffney

• Contact email

  c.gaffney@lancaster.ac.uk

• Sponsor organisation

  Lancaster University

• Clinicaltrials.gov Identifier

  NCT04477746

• Clinicaltrials.gov Identifier

  NA, NA

• Duration of Study in the UK

  2 years, 0 months, 1 days

• Research summary

  Summary of Research
  Surgeons are performing an increasing number of minimal access procedures because these offer certain advantages including improved recovery times. However, this also results in surgeons operating for longer periods which inevitably increases the already known prevalence of work-related Musculoskeletal (MSK) injuries amongst surgeons. Work-related MSK disorders account for 26 – 47.5% of illnesses and injuries due to overexertion and repetitive use, in professionals with ergonomically challenging jobs.
  Robotic-assisted laparoscopic surgery (RALS) is a modern technology that could help mitigate these MSK problems and thereby improve patient care. In comparison to standard laparoscopic surgery (LS), RALS offers steadier wrist movements with a reduced fulcrum effect, thus benefiting the patient.
  No study has compared the demands of RALS vs. LS on musculoskeletal fatigue (and subsequent injury risk) and whether these changes are underpinned by changes in cognitive fatigue. We need to determine whether a career using RALS is associated with better musculoskeletal health of surgeons than standard LS when performing complex minimally invasive procedures.
  The study will recruit Surgeons who perform prostate and bowel surgical procedures who have experience using RALS and/or LS. Surgeons will complete a series of validated questionnaires before and after each surgery to subjectively determine musculoskeletal strain/pain and cognitive fatigue and will have body composition quantified.
  They will be fitted with both EMG (to measure muscle fatigue) and EEG (to measure cognitive fatigue) whilst performing real-life surgery.
  Analysis of data gathered will be used to show what the short- and long- term musculoskeletal demands are and in turn determine if these are associated with changes in motor control and cognitive fatigue.
  Our postulated hypothesis is that RALS should have less musculoskeletal effects both short and long term on surgeons, therefore, highlighting the fact that the implementation of RALS should be less controversial, because in the long run, the most expensive objects in the operating room are the personnel

  Summary of Results
  The study was conducted with thirteen male surgeons who performed two different types of surgeries: laparoscopic (LS) and robotic (RS). During the surgeries, we measured the electrical activity in the surgeons' muscles and brains.

  The results showed that the LS group had higher muscle activation in certain muscles on the right side of the body than the left. Specifically, the right deltoid, upper trapezius, and latissimus dorsi muscles had significantly more activity than their left counterparts. In both surgical modalities, the right biceps had more muscle activation than the left.

  We also observed that the time of surgery had a significant effect on the electrical activity in the surgeons' brains, as measured by EEG. Additionally, we found that the RS surgeries required more cognitive effort than the LS surgeries, as evidenced by higher levels of activity in alpha brain waves.

  In simpler terms, the study found that surgeons had different levels of muscle and brain activity during different types of surgeries. The laparoscopic surgeries resulted in more activity on the right side of the body, while both types of surgeries had more activity in the right biceps. The time of surgery affected the surgeons' brain activity, and robotic surgeries required more cognitive effort than laparoscopic surgeries

• REC name

  East of Scotland Research Ethics Service REC 1

• REC reference

  20/ES/0081

• Date of REC Opinion

  24 Sep 2020

• REC opinion

  Further Information Favourable Opinion