Noise exposure on surgeons using robotic surgical equipment for total knee arthroplasty

Objectives Occupational noise is a major issue in orthopedic surgery due to the prevalent use of power tools. In recent years, there has been a tremendous increase in the usage of robotic surgical equipment (RSE) in health care. One disadvantage of using RSE is the exposure to high noise levels for those in the vicinity of the robot. This study assessed noise levels associated with the Mako robotic surgical system in the performance of total knee replacement (TKR) surgeries. Methods Noise measurements were conducted using a dosimeter in the orthopedic operating room (OR). The maximum peak noise level (LCpeak) and the equivalent continuous noise level (LAeq = average sound level for a period of time) for each activity or piece of equipment were determined to estimate the daily dosage of noise (LEX, 8h) for OR personnel. Noise levels were assessed with reference to occupational noise regulations in Australia. Results The Mako robotic system produced the highest LAeq (89.5 dBA), while the maximum peak noise level was recorded during the use of the hammer (126.6 dBC). The surgeon was found to be exposed to the highest average sound level (LAeq), maximum peak noise level (LCpeak), and greatest daily dosage of noise (LEX, 8h). Conclusion As noisy equipment and instruments are used intermittently, the noise regulations were technically not exceeded when averaged throughout the session. However, noise levels in the OR were sufficiently high to warrant consideration of hearing protection for OR personnel during total knee arthroplasty, particularly for sessions where multiple surgeries are undertaken.