title: Ergonomic deficits in robotic gynecologic oncology surgery: a need for intervention.
abstract: OBJECTIVE
  To evaluate surgeon strain using validated ergonomic assessment tools.
  
  
  METHODS
  Observational study (Canadian Task Force classification III).
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Robotic surgeons performing gynecologic oncology surgical procedures.
  
  
  METHODS
  Videotape footage of surgeons performing robotic gynecologic oncology procedures was obtained. A human factors engineer experienced with health care ergonomics analyzed the video recordings and performed ergonomic evaluations of the surgeons.
  
  
  RESULTS
  An initial evaluation was conducted using the Rapid Upper Limb Assessment (RULA) survey, an ergonomic assessment and prioritization method for determining posture, force, and frequency concerns with focus on the upper limbs. A more detailed analysis followed using the Strain Index (SI) method, which uses multiplicative interactions to identify jobs that are potentially hazardous. Seventeen hours of video recordings were analyzed, and descriptive data based on RULA/SI analysis were collected. Ergonomic evaluation of surgeon activity resulted in a mean RULA score of 6.46 (maximum possible RULA score, 7), indicating a need for further investigation. The mean SI grand score was 24.34. SI scores >10 suggest a potential for hazard to the operator. Thus, the current use of the surgical robot is potentially dangerous with regards to ergonomic positioning and should be modified.
  
  
  CONCLUSIONS
  At a high-volume robotics center, there are ergonomics deficits that are hazardous to gynecologic surgeons and suggest the need for modification and intervention. A training strategy must be developed to address these ergonomic issues and knowledge deficiencies.
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Renatta
authors.initials: R
authors.lastname: Craven
authors.forename: Jason
authors.initials: J
authors.lastname: Franasiak
authors.forename: Prithima
authors.initials: P
authors.lastname: Mosaly
authors.forename: Paola A
authors.initials: PA
authors.lastname: Gehrig
mesh_terms: D006804:Ergonomics; D013509:Gynecologic Surgical Procedures; D006801:Humans; D060051:Occupational Injuries / Q000517:prevention & control*; D056888:Patient Positioning; D018570:Risk Assessment; D012371:Robotics
keywords: Ergonomics; Occupational strain; Rapid upper limb assessment; Robotic surgery; Strain Index