SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Should All Minimal Access Surgery Be Robot-Assisted? A Systematic Review into the Musculoskeletal and Cognitive Demands of Laparoscopic and Robot-Assisted Laparoscopic Surgery.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Resection quality and oncologic outcomes after robotic versus laparoscopic total mesorectal excision for mid and low rectal cancer: a systematic review and meta-analysis of randomised trials.Journal of robotic surgery · 2026Pooled it
- Redefining surgical ergonomics: a systematic review of ergonomic outcomes in robotic urological surgery.Journal of robotic surgery · 2025Pooled it
- Costs of robotic and laparoscopic bariatric surgery: a systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Robot-assisted laparoscopy does not have demonstrable advantages over conventional laparoscopy in endometriosis surgery: a systematic review and meta-analysis.Surgical endoscopy · 2024Pooled it
- Evaluation of ergonomics using the DEXTERSurgical endoscopy · 2026Trial
- Impact of a full clinical workday on surgical performance in simulated laparoscopy: a controlled crossover trial.BMC medical education · 2026Trial
- Adjusted trend analysis in the adoption and outcomes of minimally invasive pancreaticoduodenectomy approaches: over a decade of contemporary U.S. data.Surgical endoscopy · 2026Article
- Instructional Design for Surgical Novices Based on Cognitive Load Theory: Implications for Urologic Surgery Training.International journal of urology : official journal of the Japanese Urological Association · 2026Review
- Colorectal Cancer Surgery: Laparoscopic vs. Robotic Approaches-A Review of the Literature.Journal of clinical medicine · 2026Review
- Surgeon posture evaluation during simulated laparoscopic and robotic-assisted cholecystectomy.International journal of computer assisted radiology and surgery · 2026Article
- Recent advances in robotic-assisted laminectomy in spine surgery: a narrative review.Asian spine journal · 2026Article
- Comparative analysis of short-term outcomes, inflammatory markers, and complications in robotic-assistedJournal of thoracic disease · 2026Article
- Critical analysis on the assessment of ergonomics in robotic surgery: A scoping review.Journal of robotic surgery · 2026Article
- Ergonomic evaluation of the Senhance® robotic system in minimally invasive gynecologic procedures versus conventional laparoscopy: an exploratory study focusing on surgeon's muscle activity.Archives of gynecology and obstetrics · 2026Article
- Ergonomic advantages of the open console system in robotic colorectal resection: reduced musculoskeletal strain with preserved technical performance - a post hoc analysis of a randomized controlled trial.International journal of surgery (London, England) · 2026Article
- Electromyography in abdominal laparoscopic and robot-assisted laparoscopic surgery: A scoping review.PloS one · 2026Article
- Artificial intelligence-assisted video analysis for evaluating ergonomic strain in robotic surgeons: a pilot study from the SAGES ergonomics task force.Surgical endoscopy · 2026Article
- Comparative outcomes of robotic single-port vNOTES versus robotic-Xi assisted single-incision transumbilical surgery for hysterectomy.Frontiers in surgery · 2026Article
- Hugo™ robotically assisted surgery versus laparoscopic hysterectomy for benign gynecological diseases: a secondary data analysis of clinical records in Panama.BMC surgery · 2025Article
- Obstetrics and Gynecology Trainees Face Higher Musculoskeletal Demands than General Surgery Trainees in Simulated Laparoscopic Tasks-An Observational Study.Healthcare (Basel, Switzerland) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSurgeons 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.
methodsMedline, 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.
resultsTwo 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.
conclusionsEvidence 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.
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Registered trials
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.