Evidence map›Paper›PMID 30341653›Full record

ArticleSurgical endoscopy2019

Ergonomics of minimally invasive surgery: an analysis of muscle effort and fatigue in the operating room between laparoscopic and robotic surgery.

Priscila R Armijo, Chun-Kai Huang, Robin High, Melissa Leon, Ka-Chun Siu, Dmitry Oleynikov

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 5 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 86 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Priscila R ArmijoCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Chun-Kai HuangCollege of Allied Health Professions, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE, 68198-4420, USA.
Robin HighDepartment of Biostatistics, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE, 68198-4375, USA.
Melissa LeonCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Ka-Chun SiuCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Dmitry OleynikovCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA. doleynik@unmc.edu.ORCID 0000-0002-0656-6596
Nebraska Medical Center · USUniversity of Nebraska Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOur aim was to determine how objectively-measured and self-reported muscle effort and fatigue of the upper-limb differ between surgeons performing laparoscopic (LAP) and robotic-assisted (ROBOT) surgeries.

methodsSurgeons performing LAP or ROBOT procedures at a single-institution were enrolled. Objective muscle activation and self-reported fatigue were evaluated, and comparisons were made between approaches. Muscle activation of the upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis (FCR), and extensor digitorum (ED) were recorded during the surgical procedure using Trigno wireless surface electromyography (EMG). The maximal voluntary contraction (MVC) was obtained to normalize root-mean-square muscle activation as %MVC

results28 surgeries were recorded (LAP: N = 18, ROBOT: N = 10). EMG analysis revealed the ROBOT group had a higher muscle activation than LAP for UT (37.7 vs. 25.5, p = 0.003), AD (8.9 vs. 6.3, p = 0.027), and FCR (14.4 vs. 10.9, p = 0.019). Conversely, LAP required more effort for the ED, represented by a significantly lower MDF compared to the ROBOT group (91.2 ± 1.5 Hz vs. 102.8 ± 1.5 Hz, p < 0.001). Survey analysis revealed no differences in self-reported fatigue before and after the surgery between approaches, p = 0.869.

conclusionsOur analysis revealed surgeons show similar fatigue levels performing the first case of the day using either robotic or LAP surgery. Surgeons performing LAP surgery had more fatigue in the forearm, robotic surgery required more shoulder and neck use, but neither was superior. Neither technique produced significant overall fatigue on survey. Long-term selective use of these different muscles could be correlated with different patterns of injury. Future studies are needed to fully understand long-term implications of prolonged surgery on occupational injury.

Indexed as

LaparoscopyMan-Machine SystemsMuscle FatigueRobotic Surgical ProceduresAdultElectromyographyFemaleForearmHumansMaleMuscle, SkeletalNeckOperating RoomsSelf ReportShoulderSurgeonsElectromyographyErgonomicsMinimally invasive surgeryRobotic surgery

Identifiers

PMID30341653
OpenAlexW2896944734

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.