Comparison between magnetic anchoring and guidance system camera-assisted laparoendoscopic single-site surgery nephrectomy and conventional laparoendoscopic single-site surgery nephrectomy in a porcine model: focus on ergonomics and workload profiles.
OBJECTIVE
To compare surgeon-assessed ergonomic and workload demands of magnetic anchoring and guidance system (MAGS) laparoendoscopic single-site surgery (LESS) nephrectomy with conventional LESS nephrectomy in a porcine model.


METHODS
Participants included two expert and five novice surgeons who each performed bilateral LESS nephrectomy in two nonsurvival animals using either the MAGS camera or conventional laparoscope. Task difficulty and workload demands of the surgeon and camera driver were assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Surgeons were also asked to score 6 parameters on a Likert scale (range 1=low/easy to 5=high/hard): procedure-associated workload, ergonomics, technical challenge, visualization, accidental events, and instrument handling. Each step of the nephrectomy was also timed and instrument clashing was quantified.


RESULTS
Scores for each parameter on the Likert scale were significantly lower for MAGS-LESS nephrectomy. Mean number of internal and external clashes were significantly lower for the MAGS camera (p<0.001). Mean task times for each procedure were shorter for experts than for novices, but this was not statistically significant. NASA-TLX workload ratings by the surgeon and camera driver showed that MAGS resulted in a significantly lower workload than the conventional laparoscope during LESS nephrectomy (p<0.05).


CONCLUSIONS
The use of the MAGS camera during LESS nephrectomy lowers the task workload for both the surgeon and camera driver when compared to conventional laparoscope use. Subjectively, it appears to also improve surgeons' impressions of ergonomics and technical challenge. Pending approval for clinical use, further evaluation in the clinical setting is warranted.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, USA.
Woong Kyu
WK
Han
Yung K
YK
Tan
Ephrem O
EO
Olweny
Gang
G
Yin
Zhuo-Wei
ZW
Liu
Stephen
S
Faddegon
Daniel J
DJ
Scott
Jeffrey A
JA
Cadeddu
D000818:Animals; D002983:Clinical Competence; D006804:Ergonomics; D010535:Laparoscopy / Q000295:instrumentation; D008280:Magnetics / Q000295:instrumentation; D023421:Models, Animal; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods; D010820:Physicians; D034421:Sus scrofa / Q000601:surgery; D013997:Time Factors; D016526:Workload; D006801:Humans