The well-being of the gynecological surgeon improves with the robot-assisted surgery

Abstract

Objectives: To demonstrate that robotic surgery benefits the ergonomics of the surgeon and his assistant compared to conventional laparoscopy through an ergonomics and satisfaction survey. Methods: Cross-sectional observational study of consecutive gynecological surgeries, which involve at least one hysterectomy, performed with robotic assistance (Da Vinci System) or with conventional laparoscopy at the Hospital Clínico San Carlos during the years 2008 and 2021. A questionnaire was administered to the main surgeon and the assistant in order to know their subjective impressions regarding comfort, ergonomics, and satisfaction with the da Vinci robotic system or laparoscopy. The responses were collected using a visual analog scale that scored from 1 (worst condition) to 10 (best condition). The comparison of the variables was made using the Student’s t test or the Mann-Whitney U test for independent samples. Significance was considered with a value of p<0.05. Results: A complete response to the questionnaire was obtained in 384 out of 451 cases (242 robotic and 142 laparoscopic). With equal difficulty perceived by the main surgeon, robotic surgery was rated as less tiring, more comfortable, and with less limb and back pain than laparoscopic surgery (p<0.001). The surgeon considered that the 3D vision, the articulation of the instrument and the ergonomics offered by robotics were relevant, as well as that robotics, was an advance over laparoscopy and open surgery regardless of the level of experience or the complexity of the procedure. No differences were found between robotic and laparoscopic surgery in the assistant assessment, except when the assistant was a senior surgeon, who found a better degree of comfort and less limb pain in the robotic approach (p<0.05). Conclusions: Robotic surgery has clear advantages for the surgeon, since it increases the degree of satisfaction and comfort, reducing fatigue and discomfort due to the position compared to conventional laparoscopy regardless surgeon’s experience and complexity of the intervention.