ArticleSurgical endoscopy2026
Ergonomic impact of closed-console (Da Vinci Xi) versus open-console (Hugo RAS) robotic systems: an ex vivo randomized crossover controlled trial.
Article 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.
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Abstract
backgroundRobotic technology, based on either open- or closed-console systems, has improved precision, visualization, and ergonomics for surgeons. However, its effects on surgeons' visual health and ocular function have not been studied.
methodsA randomized crossover trial was conducted among 20 stereo-enabled surgery residents. They were randomly allocated into closed-console (DaVinci Surgical system) or open-console (Hugo
resultsBoth groups had comparable demographics and ophthalmic parameters at baseline. After simulated task, open-console group had significant worsening in tearing (p = 0.042), while close console group had significant deterioration in neck stiffness (p=0.018), neck discomfort (p = 0.046), and upper back discomfort (p = 0.019). Within-platform analysis showed post-task increase in pressure around eyes (p = 0.011), dry eyes (p = 0.008), heaviness of eyelids (p = 0.007), headache (p = 0.025), eye pain (p = 0.024), worsened NPC (p = 0.014), and declined TBUT (right: p = 0.044; left: p = 0.022) in open console. Closed-console group had increased pressure around eyes (p = 0.015), dry eyes (p = 0.013), heaviness of eyelids (p = 0.042); worsened NPC (p = 0.009), and declined left-eye TBUT (p = 0.010).
conclusionBoth robotic systems have negative ocular impact, although more with open console. Musculoskeletal discomfort was more on closed console. These findings emphasize the need for ocular and ergonomic training and console design improvements.
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