Self-reported prevalence of injury and discomfort experienced by surgeons performing traditional and robot-assisted lapa
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and Other Interventional Techniques
REVIEW ARTICLE
Self‑reported prevalence of injury and discomfort experienced by surgeons performing traditional and robot‑assisted laparoscopic surgery: a meta‑analysis demonstrating the value of RALS for surgeons Jaime Hislop1 · Chris Hensman2,3 · Mats Isaksson1 · Oren Tirosh4,5 · John McCormick6 Received: 22 March 2020 / Accepted: 10 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The negative impact of traditional laparoscopic surgery (TLS) on surgeons has been well-established. Prevalence rates of discomfort and injury between 73% and 90% are regularly cited to support this, with robot-assisted laparoscopic surgery (RALS) often being presented as the solution. The purpose of this study was to systematically review pain studies of TLS and RALS surgeons, to consider the difference in the reported strain in general and concerning specific sites of the body. Methods PubMed, Embase, and Cochrane databases were searched in October 2019. The resulting articles were screened to ensure the full text was available in English, original data were presented, the study contained pain statistics for TLS or RALS, and the study had a long-term rather than an intra-operative focus. Quality was assessed using the SUrvey Reporting GuidelinE (SURGE). Results from studies were analyzed in two stages for TLS and RALS according to each anatomic region. Results A total of 1354 papers were found, from which 28 papers were chosen for inclusion. The average quality score of the included articles was 14.8. The risk ratio of experiencing symptoms related to TLS in comparison to RALS was 1.29; however, this was not significant. Discomfort was significantly more likely to be experienced in the back, elbows, and wrists/ hands for those practicing TLS in comparison with RALS. The regions associated with the highest risk of injury for TLS and RALS were the back and neck, respectively. Conclusions There is limited evidence in this study for the possibility that RALS is ergonomically more beneficial for the surgeon in comparison with TLS. Further analysis would be improved with the publication of larger, high-quality, homogenous studies, especially concerning injuries experienced by RALS surgeons, to overcome the limitations of heterogeneity and bias. Keywords Robot-assisted laparoscopic surgery (RALS) · Traditional laparoscopic surgery (TLS) · Ergonomics · Injury · Discomfort Soon after the first cholecystectomy was performed using traditional laparoscopic surgery (TLS) in 1987, the ergonomic challenges of the technique became obvious and Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-07810-2) contains supplementary material, which is available to authorized users. * Jaime Hislop [email protected] 1
Department of Mechanical Engineering and Product Design Engineering, Swinburne University of Technology, Melbourne, Australia
Monash University Department of Surgery and University of
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