Evidence map›Paper›PMID 42545524›Full record

Trial reportSurgical endoscopy2026

Evaluation of ergonomics using the DEXTER

Dolores T Krauss, Matilda Krones, Lisa Abry, Fabiana Castronovo, Jennifer A Eckhoff, Stefanie Brunner, Benjamin Babic, Michael Müller, Marietta Gulz, Nico Seeger and 4 more

Abstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Dolores T KraussDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Matilda KronesDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Lisa AbryDepartment of Visceral and Thoracic Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
Fabiana CastronovoDepartment of Gynecology and Obstetrics, Bern University, University of Bern, Bern, Switzerland.
Jennifer A EckhoffDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Stefanie BrunnerDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Benjamin BabicDepartment of General and Visceral Surgery, Sana Klinikum Offenbach, Offenbach Am Main, Germany.
Michael MüllerDepartment of Gynecology and Obstetrics, Bern University, University of Bern, Bern, Switzerland.
Marietta GulzDepartment of Gynecology and Obstetrics, Bern University, University of Bern, Bern, Switzerland.
Nico SeegerDepartment of Visceral and Thoracic Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
Ryan C BroderickDivision of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, CA, USA.
Nikita TharejaDivision of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, CA, USA.
Christiane J BrunsDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Hans F FuchsDepartment for General, Visceral, Thoracic and Transplant Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Hans.fuchs@uk-koeln.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe implications of complex robotic surgery on the well-being of surgeons remains widely unexplored. The DEXTER Robotic Surgery System offers an open concept where the surgeon console can be used in a sterile manner, allowing flexibility to switch between the robotic system and conventional laparoscopy. The aim of this study was to evaluate surgical ergonomics during the use of the DEXTER Robotic System.

methodsA prospective, non-randomized international multicenter trial evaluating surgical ergonomics during the routine clinical practice was performed in Switzerland and USA. A photo camera captured the surgeon's posture at the console during surgery. Using picture editing programs, image analyses were created showing the surgeon's average posture and corresponding angles. Furthermore, sound levels were measured during cases. Data were compared to previous measurements (n = 33 surgeries) of a closed console robotic system using the same methodology.

resultsA total of 83,025 images from 40 surgical procedures were analyzed, performed by five surgeons. Knee, back, and elbow angles were within recommended ergonomic limits whereas neck and hip positions were classified as high-risk. Compared with a closed console robotic system, neck posture was significantly improved (p value 0.0001). Mean sound levels were 60.24 dB for all surgeries. Comparison to a robotic system with a closed console revealed a statistically quieter OR setting for the open DEXTER system (mean sound level 64.35 dB vs. 59.5 dB; p value 0.0001).

conclusionThe application of ergonomic measurements during a real-life setting for robotic surgery helped to reveal ergonomic advantages and challenges faced when using a new robotic technology. This is the first study providing ergonomic insights in the DEXTER surgical system, identifying individual possibilities for improvement. Future studies and recommendations will may lay the foundation for a personalized training and education in surgical ergonomics leading to a healthier workspace for all surgeons and their future careers.

Indexed as

ErgonomicsLaparoscopyRobotic Surgical ProceduresEquipment DesignHumansPostureProspective StudiesSwitzerlandDEXTER Robotic Surgery SystemPostureRobotic surgerySurgical ergonomicsWorkflow

Identifiers

PMID42545524
PMCPMC13633363

What OpenQuestion holds

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Registered trials

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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.