Effect of forearm compression sleeve on muscle fatigue during robotic surgery: a randomized controlled study.

Purpose: The aim of the study was to investigate whether wearing a forearm compression sleeve during robotic surgery (RS) reduces muscle fatigue.

Methods: A randomized controlled study of consecutive RS cases was performed with three right-handed surgeons randomly allocated to wear a non-graduated compression sleeve over either his right or left forearm. Hand-grip strength was assessed at the beginning and at the 2-hour mark during the robotic console component of surgery, using a handgrip dynamometer. The maximum strength (F_max) and mean grip strength (F_mean) were calculated after 10 measurements. Effectiveness of the forearm sleeve was tested primarily by the difference in mean grip strength, and secondarily by the difference in fatigue ratio (F_max/F_mean) and recovery ratio at the two time points.

Results: Thirty-two robotic cases were performed during the study period. Wearing of a compression sleeve (compared with no sleeve) on the left forearm resulted in an increase (rather than a decrease) in mean hand-grip strength after 2 hours of RS (0.5 kg increase vs. 1.3 kg decrease, p = 0.03; 95% confidence interval, 0.20-∞). Wearing a compression sleeve (compared with no sleeve) on the right forearm did not result in an improvement in grip strength reduction (1.7 kg decrease vs. 1.1 kg decrease, p = 0.79).

Conclusion: There was a statistically significant reduction in muscle fatigue with wearing a forearm compression sleeve on the nondominant left forearm during RS.