title: Surgeons' physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study.
abstract: It is commonly believed that robotic surgery systems provide surgeons with an ergonomically sound work environment; however, the actual experience of surgeons practicing robotic surgery (RS) has not been thoroughly researched. In this ergonomics survey study, we investigated surgeons' physical symptom reports and their association with factors including demographics, specialties, and robotic systems.
  
  
  
  Four hundred and thirty-two surgeons regularly practicing RS completed this comprehensive survey comprising 20 questions in four categories: demographics, systems, ergonomics, and physical symptoms. Chi-square and multinomial logistic regression analyses were used for statistical analysis.
  
  
  
  Two hundred and thirty-six surgeons (56.1 %) reported physical symptoms or discomfort. Among those symptoms, neck stiffness, finger, and eye fatigues were the most common. With the newest robot, eye symptom rate was considerably reduced, while neck and finger symptoms did not improve significantly. A high rate of lower back stiffness was correlated with higher annual robotic case volume, and eye symptoms were more common with longer years practicing robotic surgery (p < 0.05). The symptom report rate from urology surgeons was significantly higher than other specialties (p < 0.05). Noticeably, surgeons with higher confidence and helpfulness levels with their ergonomic settings reported lower symptom report rates. Symptoms were not correlated with age and gender.
  
  
  
  Although RS provides relatively better ergonomics, this study demonstrates that 56.1 % of regularly practicing robotic surgeons still experience related physical symptoms or discomfort. In addition to system improvement, surgeon education in optimizing the ergonomic settings may be necessary to maximize the ergonomic benefits in RS.
authors: Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street Blalock 1210, Baltimore, MD, 21287, USA. glee49@jhmi.edu.
authors: G I
authors: GI
authors: Lee
authors: Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street Blalock 1210, Baltimore, MD, 21287, USA.
authors: M R
authors: MR
authors: Lee
authors: Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: I
authors: I
authors: Green
authors: Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: M
authors: M
authors: Allaf
authors: Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street Blalock 1210, Baltimore, MD, 21287, USA.
authors: M R
authors: MR
authors: Marohn
mesh_terms: D000328:Adult; D006804:Ergonomics; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D065287:Robotic Surgical Procedures; D066231:Surgeons; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Da Vinci; Discomfort; Ergonomics; Physical symptom; Robotic surgery; Survey