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Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study.
J Minim Invasive Gynecol. 2015 Feb; 22(2):234-8.JM

Abstract

STUDY OBJECTIVE

To compare resident, fellow, and attending urologic and gynecologic surgeons' musculoskeletal and mental strain during laparoscopic and robotic sacrocolpopexy.

DESIGN

Prospective cohort study (Canadian Task Force classification II-2).

SETTING

Academic medical center.

PATIENTS

Patients who underwent robotic or laparoscopic sacrocolpopexy from October 2009 to January 2011.

INTERVENTIONS

The Body Part Discomfort (BPD) survey was completed before cases, and the National Aeronautics and Space Administration Task Load Index and BPD survey were completed after cases. Higher scores on BPD and the National Aeronautics and Space Administration Task Load Index indicate greater musculoskeletal discomfort and mental strain. BPD scores were averaged over the following body regions: head/neck, back, hand/wrist, arms, and knees/ankles/feet. Changes in body region-specific discomfort scores were the primary outcomes.

MEASUREMENTS AND MAIN RESULTS

Multivariable analysis was performed using mixed-effects linear regression with surgeon as a random effect. Sixteen surgeons participated (53% fellows, 34% residents, and 13% attendings). Thirty-three robotic and 53 laparoscopic cases were analyzed, with a median surgical time of 231 minutes (interquartile range, 204-293 minutes) versus 227 minutes (interquartile range, 203-272 minutes; p = .31), a median estimated blood loss of 100 mL (interquartile range, 50-175 mL) versus 150 mL (interquartile range, 50-200 mL; p = .22), and a mean patient body mass index of 27 ± 4 versus 26 ± 4 kg/m(2) (p = .26), respectively. Robotic surgeries were associated with lower neck/shoulder (-0.19 [interquartile range, -0.32 to -0.01], T = -2.49) and back discomfort scores (-0.35 [interquartile range, -0.58 to 0], T = -2.38) than laparoscopic surgeries. Knee/ankle/foot and arm discomfort increased with case length (0.18 [interquartile range, 0.02-0.3], T = 2.81) and (0.07 [interquartile range, 0.01-0.14], p = .03), respectively.

CONCLUSION

Surgeons performing minimally invasive sacrocolpopexy experienced less neck, shoulder, and back discomfort when surgery was performed robotically.

Authors+Show Affiliations

Division of Female Medicine and Reconstructive Surgery, Departments of Obstetrics/Gynecology and Urology, Cleveland Clinic Foundation, Cleveland, Ohio; Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: megan.tarr@gmail.com.Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio.Division of Female Medicine and Reconstructive Surgery, Departments of Obstetrics/Gynecology and Urology, Cleveland Clinic Foundation, Cleveland, Ohio.Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio.Section of Biostatistics, Qualitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio.Division of Female Medicine and Reconstructive Surgery, Departments of Obstetrics/Gynecology and Urology, Cleveland Clinic Foundation, Cleveland, Ohio.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25315401

Citation

Tarr, Megan E., et al. "Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: a Pilot Study." Journal of Minimally Invasive Gynecology, vol. 22, no. 2, 2015, pp. 234-8.
Tarr ME, Brancato SJ, Cunkelman JA, et al. Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study. J Minim Invasive Gynecol. 2015;22(2):234-8.
Tarr, M. E., Brancato, S. J., Cunkelman, J. A., Polcari, A., Nutter, B., & Kenton, K. (2015). Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study. Journal of Minimally Invasive Gynecology, 22(2), 234-8. https://doi.org/10.1016/j.jmig.2014.10.004
Tarr ME, et al. Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: a Pilot Study. J Minim Invasive Gynecol. 2015;22(2):234-8. PubMed PMID: 25315401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study. AU - Tarr,Megan E, AU - Brancato,Sam J, AU - Cunkelman,Jacqueline A, AU - Polcari,Anthony, AU - Nutter,Benjamin, AU - Kenton,Kimberly, Y1 - 2014/10/12/ PY - 2014/08/26/received PY - 2014/09/28/revised PY - 2014/10/07/accepted PY - 2014/10/16/entrez PY - 2014/10/16/pubmed PY - 2015/9/19/medline KW - Ergonomics KW - Laparoscopic KW - Robotic KW - Sacrocolpopexy SP - 234 EP - 8 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 22 IS - 2 N2 - STUDY OBJECTIVE: To compare resident, fellow, and attending urologic and gynecologic surgeons' musculoskeletal and mental strain during laparoscopic and robotic sacrocolpopexy. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Academic medical center. PATIENTS: Patients who underwent robotic or laparoscopic sacrocolpopexy from October 2009 to January 2011. INTERVENTIONS: The Body Part Discomfort (BPD) survey was completed before cases, and the National Aeronautics and Space Administration Task Load Index and BPD survey were completed after cases. Higher scores on BPD and the National Aeronautics and Space Administration Task Load Index indicate greater musculoskeletal discomfort and mental strain. BPD scores were averaged over the following body regions: head/neck, back, hand/wrist, arms, and knees/ankles/feet. Changes in body region-specific discomfort scores were the primary outcomes. MEASUREMENTS AND MAIN RESULTS: Multivariable analysis was performed using mixed-effects linear regression with surgeon as a random effect. Sixteen surgeons participated (53% fellows, 34% residents, and 13% attendings). Thirty-three robotic and 53 laparoscopic cases were analyzed, with a median surgical time of 231 minutes (interquartile range, 204-293 minutes) versus 227 minutes (interquartile range, 203-272 minutes; p = .31), a median estimated blood loss of 100 mL (interquartile range, 50-175 mL) versus 150 mL (interquartile range, 50-200 mL; p = .22), and a mean patient body mass index of 27 ± 4 versus 26 ± 4 kg/m(2) (p = .26), respectively. Robotic surgeries were associated with lower neck/shoulder (-0.19 [interquartile range, -0.32 to -0.01], T = -2.49) and back discomfort scores (-0.35 [interquartile range, -0.58 to 0], T = -2.38) than laparoscopic surgeries. Knee/ankle/foot and arm discomfort increased with case length (0.18 [interquartile range, 0.02-0.3], T = 2.81) and (0.07 [interquartile range, 0.01-0.14], p = .03), respectively. CONCLUSION: Surgeons performing minimally invasive sacrocolpopexy experienced less neck, shoulder, and back discomfort when surgery was performed robotically. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/25315401/Comparison_of_postural_ergonomics_between_laparoscopic_and_robotic_sacrocolpopexy:_a_pilot_study_ DB - PRIME DP - Unbound Medicine ER -