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Wong SW, Parkes A, Crowe P. Ergonomic interventions to reduce upper limb musculoskeletal pain during robotic surgery: a narrative review. J Robot Surg 2024; 18:224. [PMID: 38801617 PMCID: PMC11130008 DOI: 10.1007/s11701-024-01992-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
There is a high prevalence of upper limb musculoskeletal pain among robotic surgeons. Poor upper limb ergonomic positioning during robotic surgery occurs when the shoulders are abducted, and the elbows are lifted off the console armrest. The validated rapid upper limb assessment can quantify ergonomic efficacy. Surface electromyography and hand dynamometer assessment of strength are the most common methods to assess muscle fatigue. A literature review was performed to find evidence of ergonomic interventions which reduce upper limb musculoskeletal pain during robotic surgery. There is a paucity of studies which have reported on this topic. In other occupations, there is strong evidence for the use of resistance training to prevent upper extremity pain. Use of forearm compression sleeves, stretching, and massage may help reduce forearm fatigue. Microbreaks with targeted stretching, active ergonomic training, improved use of armrest, and optimal hand controller design have been shown to reduce upper limb musculoskeletal pain. Future studies should assess which interventions are beneficial in reducing surgeon upper limb pain during robotic surgery.
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Affiliation(s)
- Shing Wai Wong
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia.
- Department of General Surgery, Prince of Wales Hospital, Sydney, NSW, Australia.
| | - Allan Parkes
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia
| | - Philip Crowe
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia
- Department of General Surgery, Prince of Wales Hospital, Sydney, NSW, Australia
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Wong SW, Lim R, Wong XJ, Crowe P. Ergonomic hand positioning overcomes visual perception mismatch in nonsimulated robotic colorectal surgery. J Surg Case Rep 2024; 2024:rjae143. [PMID: 38495050 PMCID: PMC10941812 DOI: 10.1093/jscr/rjae143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 03/19/2024] Open
Abstract
The aim of the study was to compare the internal instrument and external surgeon hand positions to determine whether visual perception mismatch (VPM) is a factor during robotic colorectal surgery. Continuous video footage of 24 consecutive robotic colorectal surgery cases were analysed concurrently with sagittal video recordings of surgeon hand positions. Separated sagittal hand positions would indicate nonergonomic positioning without clutching of the robotic controls, either matching the on-screen up/down instrument tip positions (no VPM) or in the opposite direction (true VPM). Variables (30-min surgery time blocks, anatomic target, and task performed), which resulted in hand separation or VPM, were analysed. Operating with the presence of VPM for more than one duration occurred 51 times and nonergonomic sagittal hand positioning occurred 22 times. For an experienced robotic surgeon, ergonomic positioning of the hands is favoured over adjustment for VPM despite the potential higher mental workload.
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Affiliation(s)
- Shing Wai Wong
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Ranah Lim
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
| | - Xiuling Jasmine Wong
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
| | - Philip Crowe
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
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Wong SW, Ang ZH, Lim R, Wong XJ, Crowe P. Factors affecting upper limb ergonomics in robotic colorectal surgery. J Surg Case Rep 2023; 2023:rjad632. [PMID: 38026740 PMCID: PMC10663069 DOI: 10.1093/jscr/rjad632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
The aim of the study was to examine the factors which may influence suboptimal ergonomic surgeon hand positioning during robotic colorectal surgery (RCS). An observational study of 11 consecutive RCS cases from June 2022 to August 2022 was performed. Continuous video footage of RCS cases was analysed concurrently with video recordings of surgeon's hand positions at the console. The outcome studied was the frequency with which either hand remained in a suboptimal ergonomic position outside the predetermined double box outlines, as marked on the surgeon's video, for >1 min. Situations which resulted in poor upper limb ergonomics were dissection in the peripheral operating field location, left-hand use, use of the stapler, dissection of the main mesenteric blood vessels, and multi-quadrant surgery. Being aware of situations when suboptimal ergonomic positions occur can allow surgeons to consciously compensate by using the clutch or pausing to take a rest break. What does this paper add to the literature? The study is important because it is the first to look at factors which may influence poor upper limb ergonomics during non-simulated RCS. By recognizing these factors and compensating for them, it may improve surgeon ergonomics with resultant better performance.
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Affiliation(s)
- Shing Wai Wong
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Zhen Hao Ang
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Ranah Lim
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
| | - Xiuling Jasmine Wong
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
| | - Philip Crowe
- Department of General Surgery, Prince of Wales Hospital, Sydney, New South Wales, 2031, Australia
- Randwick Campus, School of Clinical Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
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Pawa S, Kwon RS, Fishman DS, Thosani NC, Shergill A, Grover SC, Al-Haddad M, Amateau SK, Buxbaum JL, Calderwood AH, Chalhoub JM, Coelho-Prabhu N, Desai M, Elhanafi SE, Forbes N, Fujii-Lau LL, Kohli DR, Machicado JD, Marya NB, Ruan W, Sheth SG, Storm AC, Thiruvengadam NR, Qumseya BJ. American Society for Gastrointestinal Endoscopy guideline on the role of ergonomics for prevention of endoscopy-related injury: summary and recommendations. Gastrointest Endosc 2023; 98:482-491. [PMID: 37245720 DOI: 10.1016/j.gie.2023.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach to strategies to prevent endoscopy-related injury (ERI) in GI endoscopists. It is accompanied by the article subtitled "Methodology and Review of Evidence," which provides a detailed account of the methodology used for the evidence review. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline estimates the rates, sites, and predictors of ERI. Additionally, it addresses the role of ergonomics training, microbreaks and macrobreaks, monitor and table positions, antifatigue mats, and use of ancillary devices in decreasing the risk of ERI. We recommend formal ergonomics education and neutral posture during the performance of endoscopy, achieved through adjustable monitor and optimal procedure table position, to reduce the risk of ERI. We suggest taking microbreaks and scheduled macrobreaks and using antifatigue mats during procedures to prevent ERI. We suggest the use of ancillary devices in those with risk factors predisposing them to ERI.
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Affiliation(s)
- Swati Pawa
- Department of Gastroenterology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Richard S Kwon
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas S Fishman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Nirav C Thosani
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Amandeep Shergill
- Division of Gastroenterology, Department of Medicine, University of San Francisco, San Francisco, California, USA
| | - Samir C Grover
- Division of Gastroenterology, Department of Medicine, Unity Health Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Mohammad Al-Haddad
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Stuart K Amateau
- Division of Gastroenterology Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - James L Buxbaum
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Audrey H Calderwood
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jean M Chalhoub
- Department of Gastroenterology and Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA
| | | | - Madhav Desai
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Sherif E Elhanafi
- Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Nauzer Forbes
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Divyanshoo R Kohli
- Pancreas and Liver Clinic, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Jorge D Machicado
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Neil B Marya
- Division of Gastroenterology and Hepatology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA
| | - Wenly Ruan
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Sunil G Sheth
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew C Storm
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikhil R Thiruvengadam
- Division of Gastroenterology and Hepatology, Loma Linda University, Loma Linda, California, USA
| | - Bashar J Qumseya
- Department of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA
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Pawa S, Kwon RS, Fishman DS, Thosani NC, Shergill A, Grover SC, Al-Haddad M, Amateau SK, Buxbaum JL, Calderwood AH, Chalhoub JM, Coelho-Prabhu N, Desai M, Elhanafi SE, Forbes N, Fujii-Lau LL, Kohli DR, Machicado JD, Marya NB, Ruan W, Sheth SG, Storm AC, Thiruvengadam NR, Wani S, Qumseya BJ. American Society for Gastrointestinal Endoscopy guideline on the role of ergonomics for prevention of endoscopy-related injury: methodology and review of evidence. Gastrointest Endosc 2023; 98:492-512.e1. [PMID: 37245721 DOI: 10.1016/j.gie.2023.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Swati Pawa
- Department of Gastroenterology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Richard S Kwon
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas S Fishman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Nirav C Thosani
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Amandeep Shergill
- Division of Gastroenterology, Department of Medicine, University of San Francisco, San Francisco, California, USA
| | - Samir C Grover
- Division of Gastroenterology, Department of Medicine, Unity Health Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Mohammad Al-Haddad
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Stuart K Amateau
- Division of Gastroenterology Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - James L Buxbaum
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Audrey H Calderwood
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jean M Chalhoub
- Department of Gastroenterology and Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA
| | | | - Madhav Desai
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Sherif E Elhanafi
- Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Nauzer Forbes
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Divyanshoo R Kohli
- Pancreas and Liver Clinic, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Jorge D Machicado
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Neil B Marya
- Division of Gastroenterology and Hepatology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA
| | - Wenly Ruan
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Sunil G Sheth
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew C Storm
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikhil R Thiruvengadam
- Division of Gastroenterology and Hepatology, Loma Linda University, Loma Linda, California, USA
| | - Sachin Wani
- Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bashar J Qumseya
- Department of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA
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Kakaraparthi VN, Vishwanathan K, Gadhavi B, Reddy RS, Tedla JS, Samuel PS, Dixit S, Alshahrani MS, Gannamaneni VK. Application of the rapid upper limb assessment tool to assess the level of ergonomic risk among health care professionals: A systematic review. Work 2022; 71:551-564. [DOI: 10.3233/wor-210239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Work-related musculoskeletal disorders (WMSDs) and ergonomic risk factors are widespread problems in the healthcare sector. OBJECTIVE: The primary objective of this review is to evaluate the application of the Rapid Upper Limb Assessment (RULA) tool in various healthcare professionals and to assess the level of ergonomic risk among them. METHODS: The databases MEDLINE, EMBASE, CINAHL, LILACS, SCIELO, DOAJ, PubMed, and PEDro were searched with terms associated with ergonomics, assessment, health care providers, risk factors, workplace, and RULA. We reviewed the literature from 2000 to 2020, including studies assessing RULA’s effectiveness for evaluating the WMSD’s and ergonomic risk in health care practitioners. We excluded the studies which were not open access and freely available. RESULTS: Overall, 757 records were screened; of these 40 potential studies, 13 different healthcare professionals were identified as eligible for inclusion. In most studies, the RULA tool was established as an effective tool in application and evaluating the level of the ergonomic risk among them. CONCLUSIONS: The RULA tool assessed the high ergonomic risk levels in dental professionals and low ergonomic risk levels in professionals working in the pharmacy department, clearly suggesting potential changes in work postures were necessary to prevent or reduce these risk factors.
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Affiliation(s)
- Venkata Nagaraj Kakaraparthi
- Department of Physiotherapy, CR4D Unit of Parul University, Vadodara, Gujarat, India
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Karthik Vishwanathan
- Department of Orthopaedics, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
| | - Bhavana Gadhavi
- Department of Physiotherapy, Parul University, Vadodara, Gujarat, India
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Paul Silvian Samuel
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Virtual Reality Simulator Enhances Ergonomics Skills for Neurosurgeons. INT J SEMANT WEB INF 2022. [DOI: 10.4018/ijswis.297041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper aims to assess the needs of neurosurgical training in order to strategize the future plans for simulation and rehearsal. The project main objective is to investigate the ability virtual reality to enhance the training.An online questionnaire has been conducted among surgeons practicing in different countries across the globe. The study shows significant differences in rehearsal methods and surgical teaching methods practiced by the respondents. Among respondents, 90% did believe that virtual reality technology can serve surgical training, and almost all respondents agreed that there is a gap in the existing neurosurgical training in terms of operating room ergonomics. Adequate education on surgical ergonomics might lead to an improvement in the outcomes for both surgeon and patient. The contribution of the paper is two fold. From one side investigates the new requirements for the enhancement of Neurosurgenos’ training and adoption on Virtual Reality Simulator. From the other side contributes to the body of knowledge related to the required Ergonomics skills.
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Louridas M, Sachdeva AK, Yuen A, Blair P, MacRae H. Coaching in Surgical Education: A Systematic Review. Ann Surg 2022; 275:80-84. [PMID: 33856384 DOI: 10.1097/sla.0000000000004910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objectives of this study were to review the coaching literature to (1) characterize the criteria integral to the coaching process, specifically in surgery, and (2) describe how these criteria have been variably implemented in published studies. BACKGROUND Coaching is a distinct educational intervention, but within surgery the term is frequently used interchangeably with other more established terms such as teaching and mentoring. METHODS A systematic search was performed of the MEDLINE and Cochrane databases to identify studies that used coach/coaching as an intervention for surgeons for either technical or nontechnical skills. Study quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS A total of 2280 articles were identified and after screening by title, abstract and full text, 35 remained. Thirteen coaching criteria (a-m) were identified in 4 general categories: 1. overarching goal (a. refine performance of an existing skill set), 2. the coach (b. trusting partnership, c. avoids assessment, d. 2-way communication), the coachee (e. voluntary participation, f. self-reflection, g. goal setting, h. action plan, i. outcome evaluation), and the coach-coachee rapport (j. coaching training, k. structured coaching model, l. non-directive, m. open ended questions). Adherence to these criteria ranged from as high of 73% of studies (voluntary participation of coach and coachee) to as low as 7% (use of open-ended questions). CONCLUSIONS Coaching is being used inconsistently within the surgical education literature. Our hope is that with establishing criteria for coaching, future studies will implement this intervention more consistently and allow for better comparison and generalization of results.
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Affiliation(s)
- Marisa Louridas
- Department of Surgery, University of Toronto, Toronto, Ontario
| | - Ajit K Sachdeva
- Division of Education, American College of Surgeons, Chicago, Illinois
| | - Andrew Yuen
- Department of Surgery, University of Toronto, Toronto, Ontario
| | - Patrice Blair
- Division of Education, American College of Surgeons, Chicago, Illinois
| | - Helen MacRae
- Department of Surgery, University of Toronto, Toronto, Ontario
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Kanji F, Catchpole K, Choi E, Alfred M, Cohen K, Shouhed D, Anger J, Cohen T. Work-system interventions in robotic-assisted surgery: a systematic review exploring the gap between challenges and solutions. Surg Endosc 2021; 35:1976-1989. [PMID: 33398585 DOI: 10.1007/s00464-020-08231-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The introduction of a robot into the surgical suite changes the dynamics of the work-system, creating new opportunities for both success and failure. An extensive amount of research has identified a range of barriers to safety and efficiency in Robotic Assisted Surgery (RAS), such as communication breakdowns, coordination failures, equipment issues, and technological malfunctions. However, there exists very few solutions to these barriers. The purpose of this review was to identify the gap between identified RAS work-system barriers and interventions developed to address those barriers. METHODS A search from three databases (PubMed, Web of Science, and Ovid Medline) was conducted for literature discussing system-level interventions for RAS that were published between January 1, 1985 to March 17, 2020. Articles describing interventions for systems-level issues that did not involve technical skills in RAS were eligible for inclusion. RESULTS A total of 30 articles were included in the review. Only seven articles (23.33%) implemented and evaluated interventions, while the remaining 23 articles (76.67%) provided suggested interventions for issues in RAS. Major barriers identified included disruptions, ergonomic issues, safety and efficiency, communication, and non-technical skills. Common solutions involved team training, checklist development, and workspace redesign. CONCLUSION The review identified a significant gap between issues and solutions in RAS. While it is important to continue identifying how the complexities of RAS affect operating room (OR) and team dynamics, future work will need to address existing issues with interventions that have been tested and evaluated. In particular, improving RAS-associated non-technical skills, task management, and technology management may lead to improved OR dynamics associated with greater efficiency, reduced costs, and better systems-level outcomes.
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Affiliation(s)
- Falisha Kanji
- Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA
| | - Ken Catchpole
- Medical University of South Carolina, Charleston, SC, USA
| | - Eunice Choi
- Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA
| | - Myrtede Alfred
- Medical University of South Carolina, Charleston, SC, USA
| | - Kate Cohen
- Enterprise Information Services, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel Shouhed
- Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA
| | - Jennifer Anger
- Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA
| | - Tara Cohen
- Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA.
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Gómez-Galán M, Callejón-Ferre ÁJ, Pérez-Alonso J, Díaz-Pérez M, Carrillo-Castrillo JA. Musculoskeletal Risks: RULA Bibliometric Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4354. [PMID: 32560566 PMCID: PMC7345928 DOI: 10.3390/ijerph17124354] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 02/05/2023]
Abstract
The objective of this study was to reveal RULA method applications in terms of the knowledge, country, year and journal categories. The search was performed using the "Web of Science Core Collection". The period from 1993 to April 2019 was selected. Eight hundred nine results were obtained, of which 226 were used. The largest number of publications was determined to be in the fields of industry and health and social assistance, which coincides with the OWAS and Standardized Nordic Questionnaire methods. By country, the USA stands out for its greater number of research studies and categories that are encompassed. By date, 2016 was the year when more studies were carried out, again coinciding with the Standardized Nordic Questionnaire. By journal, "Work-A Journal of Prevention Assessment and Rehabilitation" is highlighted, as it is for the REBA method as well. It was concluded that RULA can be applied to workers in different fields, usually in combination with other methods, while technological advancement provides benefits for its application.
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Affiliation(s)
- Marta Gómez-Galán
- Department of Engineering, University of Almería, Research Center CIMEDES (CeiA3), 04120 Almería, Spain
| | - Ángel-Jesús Callejón-Ferre
- Department of Engineering, University of Almería, Research Center CIMEDES (CeiA3), 04120 Almería, Spain
- Laboratory-Observatory Andalusian Working Conditions in the Agricultural Sector (LASA), 41092 Seville, Spain
| | - José Pérez-Alonso
- Department of Engineering, University of Almería, Research Center CIMEDES (CeiA3), 04120 Almería, Spain
| | - Manuel Díaz-Pérez
- Department of Engineering, University of Almería, Research Center CIMEDES (CeiA3), 04120 Almería, Spain
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11
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Neck/Shoulder Problems and Visual Disturbances Among Surgeons: A Scoping Review. J Surg Res 2020; 247:413-428. [DOI: 10.1016/j.jss.2019.09.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
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12
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Hares L, Roberts P, Marshall K, Slack M. Using end-user feedback to optimize the design of the Versius Surgical System, a new robot-assisted device for use in minimal access surgery. BMJ SURGERY, INTERVENTIONS, & HEALTH TECHNOLOGIES 2019; 1:e000019. [PMID: 35047780 PMCID: PMC8749308 DOI: 10.1136/bmjsit-2019-000019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/02/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background Robot-assisted minimal access surgery (MAS) reduces blood loss, recovery time, intraoperative and postoperative complications and pain. However, uptake of robotic MAS remains low, suggesting there are barriers to its use. To overcome these barriers, a new surgical robot system, Versius, was developed based on the needs and feedback of surgeons and surgical teams. Methods The surgical robot prototype was designed based on observations in the operating room (OR) and previous interviews with surgeons. Formative studies with surgeons and surgical teams were used to refine the prototype design, resulting in modifications to all components, including the arms, instruments, handgrips and surgeon console. Proof-of-concept cadaver studies were used to further optimize its design by assessing its usability during surgical procedures. Results Feedback led to the development of a novel, mobile design with independent arm carts and surgical console, linked by supported serial or parallel connections, providing maximum flexibility in the OR. Instrument tips were developed based on surgeons’ preferred designs and wristed at the tip providing seven degrees of freedom within the patient. Multiple handgrip designs were assessed by surgeons; of these, a ‘game controller’ design was rated most popular and usable. An open surgical console design allowing multiple working positions was rated highest by surgeons and the surgical teams. Conclusions This surgical robot system has been developed using feedback from end users throughout the design process and aims to minimize barriers to robotic MAS uptake. Additionally, these studies demonstrate system success in the surgical procedures it was designed for. The studies reported here, and further studies of the Versius Surgical System, are intended to align with IDEAL (Idea, Development, Exploration, Assessment, Long-term study) Framework guidance.
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