[Ergonomics in Robotic Surgery - A Practical Guide].

Abstract

Abstract: Ergonomics remain an underestimated challenge in medicine, particularly in robotic surgery. Despite technical advances, surgeons often suffer from musculoskeletal disorders often involving the neck, back, and wrist. Previous studies have shown that a lack of knowledge and awareness of ergonomic recommendations for the use of the console, unnatural or poor physiological postures, and a lack of training are common causes of poor posture and associated complaints. A physiological posture is the basis for a healthy workspace, both when standing and sitting. Of particular relevance are a neutral head, pelvis, and spine position, as well as core stability and regular training of the critical muscles for a stable posture.A comparison of different robotic systems revealed significant differences in console design and associated ergonomic challenges. Systems with adjustable headpieces, for example, improve neck posture, while open consoles facilitate communication in the operating room.In addition, the role of the bedside assistant is critical from an ergonomic perspective. The discrepancy between the motor and visual axes quickly leads to discomfort in the neck, shoulder, and arm areas. Structured training curricula and ergonomic guidelines are lacking in everyday surgical practice.To prevent musculoskeletal pain and potential disorders, targeted stretching and mobilization exercises can be performed during so-called micro breaks, which have been proven to reduce pain and improve concentration and performance. Correct adjustment of the console can also significantly improve the ergonomics in the robotic operating theatre.