Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: a Pilot Study Journal Article

Authors: Tarr, M. E.; Brancato, S. J.; Cunkelman, J. A.; Polcari, A.; Nutter, B.; Kenton, K.
Article Title: Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: a Pilot Study
Abstract: STUDY OBJECTIVE: To compare resident, fellow and attending urologic gynecologic surgeons' musculoskeletal and mental strain during laparoscopic and robotic sacrocolpopexy. DESIGN: Prospective cohort II-2 SETTING: Academic medical center PATIENTS: Patients who underwent robotic or laparoscopic sacrocolpopexy from October 2009- January 2011 INTERVENTION: The Body Part Discomfort (BPD) Survey was completed prior to cases, and NASA Task Load Index (TLX) and BPD were completed following cases. Higher scores on BPD and TLX indicate greater musculoskeletal discomfort and mental strain. BPD scores were averaged over 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. 16 surgeons participated: 53% fellows, 34% residents,13% attendings. 33 robotic and 53 laparoscopic cases were analyzed, with median surgical time 231 [204,293] vs 227 [203,272] minutes (p=.31), median EBL 100 [50,175] vs 150 [50,200] mL (p=.22), and mean patient BMI 27+/-4 vs 26+/-4 kg/m2 (p=.26), respectively. Robotic surgeries were associated with lower neck/shoulder (-0.19 [-0.32, -0.01], T=-2.49) and back discomfort scores (-0.35 [-0.58, 0], T=-2.38) than laparoscopic surgeries. Knee/ankle/foot and arm discomfort increased with case length (0.18 [0.02, 0.3], T=2.81) and (0.07 [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.
Keywords: Female Pelvic Medicine Reconstructive Surgery
Journal Title: Journal of minimally invasive gynecology
ISSN: 1553-4669; 1553-4650
Publisher: AAGL. Published by Elsevier Inc  
Date Published: 2014
Language: ENG
Notes: LR: 20141016; CI: Copyright (c) 2014; JID: 101235322; 2014/08/26 [received]; 2014/09/28 [revised]; 2014/10/07 [accepted]; aheadofprint