Anthony Dwyer’s Updates

Ergonomic Assessment of Robotic General Surgeons: A Pilot Study 

Current abstract is out for publication. I welcome your feedback. 

Abstract

Introduction: 

Inadequacies exist in the ergonomics of upper body positioning of robotic surgeons; these deficits in biomechanical efficacy predispose surgeons to musculoskeletal injury. Ergonomics and biomechanics may be objectively measured using the Rapid Entire Body Assessment (REBA) and the Rapid Upper Limb Assessment (RULA) to quantify ergonomic efficacy. The purpose of this study is to use validated ergonomic tools to assess the posture of robotic surgeons to examine deficiencies. 

Methods:  

Four robotic surgeons using the da Vinci model were observed for a minimum of 30 minutes each. An Xbox Connect camera was positioned 10 feet away from the surgeon console. Kinetisense software measured position of the head, shoulders, mid-spine, hips, and knees. One image was captured every 30 seconds. The software measured the positions in centimeters that deviated from an ideal central postural line (plumb line). RULA and REBA were also employed to asses posture using a still image at 15 minutes.   

Results: 

The average RULA score for the four surgeons was 4.75 (range 3-6). The average REBA score for the four surgeons was 7 (range 5-8).  

Conclusions: 

The average RULA score of 4.5/7 and the average REBA of 7/15 qualify as medium risk with the recommendation that action is needed to improve ergonomics. While this pilot study is limited in size, it demonstrates the need for further investigation. With more than half of surgeons reporting musculoskeletal pain after robotic surgery [1], poor posture may offer an explanation.