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Shugaba, A, Lambert, JE, Bampouras, TM, Nuttall, HE, Gaffney, CJ and Subar, DA (2022) Should All Minimal Access Surgery Be Robot-Assisted? A Systematic Review into the Musculoskeletal and Cognitive Demands of Laparoscopic and Robot-Assisted Laparoscopic Surgery. Journal of Gastrointestinal Surgery, 26. pp. 1520-1530. ISSN 1091-255X
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Abstract
Background: Surgeons are among the most at risk of work-related musculoskeletal health decline because of the physical demands of surgery, which is also associated with cognitive fatigue. Minimally invasive surgery offers excellent benefits to patients but the impact of robotic or laparoscopic surgery on surgeon well-being is less well understood. This work examined the musculoskeletal and cognitive demands of robot-assisted versus standard laparoscopic surgery. Methods: Medline, Embase and Cochrane databases were systematically searched for ‘Muscle strain’ AND ‘musculoskeletal fatigue’ AND ‘occupational diseases’ OR ‘cognitive fatigue’ AND ‘mental fatigue’ OR ‘standard laparoscopic surgery’ AND ‘robot-assisted laparoscopic surgery’. Primary outcomes measured were electromyographic (EMG) activity for musculoskeletal fatigue and questionnaires (NASA-TLX, SMEQ, or Borg CR-10) for cognitive fatigue. A systematic review was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) Guidelines. The study was preregistered on Prospero ID: CRD42020184881. Results: Two hundred and ninety-eight original titles were identified. Ten studies that were all observational studies were included in the systematic review. EMG activity was consistently lower in robotic than in laparoscopic surgery in the erector spinae and flexor digitorum muscles but higher in the trapezius muscle. This was associated with significantly lower cognitive load in robotic than laparoscopic surgery in 7 of 10 studies. Conclusions: Evidence suggests a reduction in musculoskeletal demands during robotic surgery in muscles excluding the trapezius, and this is associated with most studies reporting a reduced cognitive load. Robotic surgery appears to have less negative cognitive and musculoskeletal impact on surgeons compared to laparoscopic surgery.
| Item Type: | Article |
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| Uncontrolled Keywords: | Humans; Laparoscopy; Cognition; Robotics; Surgeons; Robotic Surgical Procedures; Cognitive; Ergonomics; Fatigue; Mental; Posture; Cognition; Humans; Laparoscopy; Robotic Surgical Procedures; Robotics; Surgeons; 1103 Clinical Sciences; Surgery |
| Subjects: | Q Science > QP Physiology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RD Surgery T Technology > T Technology (General) |
| Divisions: | Sport & Exercise Sciences |
| Publisher: | Springer Science and Business Media LLC |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 16 Aug 2022 14:18 |
| Last Modified: | 16 Aug 2022 14:18 |
| DOI or ID number: | 10.1007/s11605-022-05319-8 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/17398 |
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