title: Surgeon fatigue and postural stability: is robotic better than laparoscopic surgery?
abstract: OBJECTIVE
  To compare muscular fatigue and postural stability of surgeons before and after laparoscopic and robotic surgery.
  
  
  METHODS
  The design of this study is Class II. A consecutive cohort of patients presenting at an academic tertiary-care center for scheduled gynecologic surgery was used. Routine surgical care was examined with testing of surgeon fatigue and postural measures before and after the procedure. Motor fatigue was measured using a quantitative grip dynamometer, and postural stability was measured using a nondominant, single-leg stance. A subjective fatigue score was recorded following surgery.
  
  
  RESULTS
  Primary surgeons completed testing before and after 56 surgeries. A trend toward decline in postural stability was observed more in the laparoscopy group than in the robotic group (P=.29). The fatigue index and subjective fatigue scores were not significantly different.
  
  
  CONCLUSIONS
  Similar changes in postural stability and muscular strength were observed following laparoscopic and robotic surgery. The optimal measurement tool to capture surgical fatigue remains elusive. Fatigue differences may have been more pronounced if surgical procedure degree of difficulty had been more consistent between groups.
authors: Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, Arizona 85054, USA. butler.kristina@mayo.edu
authors: Kristina A
authors: KA
authors: Butler
authors: Vasilis E
authors: VE
authors: Kapetanakis
authors: Benn E
authors: BE
authors: Smith
authors: Mohammed
authors: M
authors: Sanjak
authors: Joseph L
authors: JL
authors: Verheijde
authors: Yu-Hui H
authors: YH
authors: Chang
authors: Paul M
authors: PM
authors: Magtibay
authors: Javier F
authors: JF
authors: Magrina
mesh_terms: D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D010535:Laparoscopy; D011187:Posture; D012371:Robotics; D013043:Specialties, Surgical