title: An ergonomic comparison of robotic and laparoscopic technique: the influence of surgeon experience and task complexity.
abstract: BACKGROUND
  This study compares the mental and physical workload of laparoscopic and robotic technique while performing simulated surgical tasks in a laboratory setting.
  
  
  METHODS
  Ten volunteer surgeons performed two tasks in a laparoscopic trainer using laparoscopic (LAP) and robotic (ROB) techniques. Outcome measures included: Task time, task-error, vertical/horizontal arm displacement, percent maximum electromyographic signal from the thenar, forearm flexor, and deltoid muscle compartments, skin conductance, and perceived difficulty and discomfort levels. A two-way repeated-measures ANOVA compared surgical technique and laparoscopic experience level (E = expert, N = novice).
  
  
  RESULTS
  For the simple task, ROB technique was slower and had higher errors, and the surgeon's arm was more elevated. For the complex task, ROB electromyographic signal was lower. Stress was lower in both tasks for ROB, but the decrease was not statistically significant.
  
  
  CONCLUSIONS
  Robotic technique appears slower and less precise than laparoscopic technique for simple tasks, but equally fast and possibly less stressful for complex tasks. Previous laparoscopic experience has a complex influence on the physical and mental adaptation to robotic surgery.
authors.affiliation: Department of Surgery, University of California Davis, Sacramento, California and Surgical Service at Contra Costa Regional Medical Center, Martinez, California 94553, USA. rberguer@yahoo.com
authors.forename: Ramon
authors.initials: R
authors.lastname: Berguer
authors.forename: Warren
authors.initials: W
authors.lastname: Smith
mesh_terms: D000328:Adult; D006804:Ergonomics; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D016526:Workload