What question did this study set out to answer?

This study aims to objectively assess and compare the ergonomics and posture of surgeons performing robotic-assisted and video-assisted lobectomies.

July 24, 2026The Cardiothoracic Surgeon0 citationsOpen Access

Objective assessment of surgeon’s ergonomics and posture in robotic-assisted (RATS) versus video-assisted thoracoscopic (VATS) lobectomy during vascular structures isolation

AEAhmed Elkhouly GSGowthanan Santhirakumaran BSBen Shanahan

Puntos clave

This study aims to objectively assess and compare the ergonomics and posture of surgeons performing robotic-assisted and video-assisted lobectomies.
Prospective observational evaluation of 59 lobectomies by seven surgeons.
Joint angles tracked using Kinovea and APECS software during real-life surgeries.
RULA scores calculated to measure ergonomic risk during vascular structures isolation.
RULA score significantly lower in RATS (4.7±0.5) compared to VATS (7.0±0.6), indicating higher ergonomic risk in VATS (p < 0.001).
Mean joint angles of neck, trunk, neck-tilt, and shoulder-tilt were significantly higher in VATS (p < 0.001).
Elbow angles were significantly greater in RATS (p < 0.001).

Resumen

Abstract Background Suboptimal ergonomic postures during surgical procedures increase the susceptibility to work-related musculoskeletal disorders. We objectively compared surgeons’ ergonomics and posture between robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) lobectomy, using the validated rapid upper limb assessment (RULA) score. Methods A prospective observational study evaluated 59 lobectomies performed by seven surgeons. Surgeon’s joint angles were tracked during real-life procedures using two software applications (Kinovea-0.9.5 and APECS platform). Sagittal and dorsal videos were recorded during robot ( n = 31) and multiportal thoracoscopic ( n = 28) lobectomies. We calculated neck, shoulder, elbow, trunk, hip, knee, and specific tilt angles to estimate the RULA scores for ergonomic risk during dissection/division of vascular structures. Data were analysed using linear mixed-effects models to adjust for intra-surgeon clustering and anthropometrics. Results The RULA score was significantly lower in the RATS (4.7±0.5) compared to VATS-group (7.0±0.6) ( p < 0.001), indicating a high ergonomic risk for surgeons in the VATS-group, versus a low-to-medium risk in the RATS-group. The mean joint angles of neck, trunk, neck-tilt and shoulder-tilt were significantly higher in VATS ( p < 0.001), while the elbow angles were significantly greater in RATS ( p < 0.001). There was no significant intergroup difference regarding shoulder angles ( p = 0.21) or operative time ( p = 0.53). A within-surgeon subgroup analysis confirmed these postural advantages are intrinsically driven by the robotic platform. Inter-software agreement between the tracking platforms was excellent (mean intraclass correlation coefficient = 0.94). Conclusions RATS demonstrated superior ergonomics and posture compared to VATS, with lower associated risk of musculoskeletal disorders. Integrating ergonomic checklists into surgical training is essential to minimize occupational injury risks.

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo