title: Intraoperative workload in robotic surgery assessed by wearable motion tracking sensors and questionnaires.
abstract: The introduction of robotic technology has revolutionized radical prostatectomy surgery. However, the potential benefits of robotic techniques may have trade-offs in increased mental demand for the surgeon and the physical demand for the assisting surgeon. This study employed an innovative motion tracking tool along with validated workload questionnaire to assess the ergonomics and workload for both assisting and console surgeons intraoperatively.
  
  
  
  Fifteen RARP cases were collected in this study. Cases were performed by 10 different participants, six primarily performed console tasks and four primarily performed assisting tasks. Participants had a median 12 (min-3, max-25) years of surgical experience. Both console and assisting surgeons performed robotic prostatectomy cases while wearing inertial measurement units (IMUs) that continuously track neck, shoulder, and torso motion without interfering with the sterile environment. Postoperatively, participants completed a workload questionnaire (SURG-TLX) and a body part discomfort questionnaire.
  
  
  
  Twenty-six questionnaires were completed from 13 assisting and 13 console surgeons over the 15 cases. Postoperative pain was reported highest for the right shoulder and neck. Mental demands were 41 % higher for surgeons at the console than assisting (p < 0.05), while physical demands were not significantly different. Assisting surgeons worked in demanding neck postures for 58 % of the procedure compared to 24 % for the console surgeon (p < 0.01). Surgeons at the console were primarily static and showed 2-5 times fewer movements than assisting surgeons (p < 0.01).
  
  
  
  Postures were more ergonomic during console tasks than when assisting by the bedside; however, the console may constrain postures leading to static loads that have been associated with musculoskeletal symptoms for the neck, torso, and shoulders. The IMU sensors were effective at quantifying ergonomics in robotic prostatectomies, and these methods and findings have broad applications to other robotic procedures.
authors: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Denny
authors: D
authors: Yu
authors: Karolinska Institutet, Stockholm, Sweden.
authors: Cem
authors: C
authors: Dural
authors: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Melissa M B
authors: MM
authors: Morrow
authors: Karolinska Institutet, Stockholm, Sweden.
authors: Liyun
authors: L
authors: Yang
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors: Justin W
authors: JW
authors: Collins
authors: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Hallbeck.Susan@mayo.edu.|Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Hallbeck.Susan@mayo.edu.
authors: Susan
authors: S
authors: Hallbeck
authors: Karolinska Institutet, Stockholm, Sweden.
authors: Magnus
authors: M
authors: Kjellman
authors: Karolinska Institutet, Stockholm, Sweden.
authors: Mikael
authors: M
authors: Forsman
mesh_terms: D000328:Adult; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology; D011187:Posture; D011468:Prostatectomy / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D020069:Shoulder Pain / Q000453:epidemiology; D066231:Surgeons; D011795:Surveys and Questionnaires; D016526:Workload
keywords: Ergonomics; Robotic surgery; Robotic-assisted radical prostatectomy; Workload