An ergonomic comparison of robotic and laparoscopic technique: The influence of surgeon experience and task complexity
An ergonomic comparison of robotic and laparoscopic technique: The influence of surgeon experience and task complexity
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DOI：
10.1016/j.jss.2005.10.003
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发表时间：
2006-07-01
影响因子：
2.2
通讯作者：
Smith, Warren
中科院分区：
文献类型：
--
作者：
Berguer, Ramon;Smith, Warren
背景。本研究比较了在实验室环境中执行模拟手术任务时腹腔镜和机器人技术的精神和身体负荷。材料和方法。十名志愿外科医生使用腹腔镜 (LAP) 和机器人 (ROB) 技术在腹腔镜训练器中执行两项任务。结果测量包括：任务时间、任务错误、垂直/水平手臂位移、来自大鱼际、前臂屈肌和三角肌室的最大肌电信号百分比、皮肤电导以及感知困难和不适水平。双向重复测量方差分析比较了手术技术和腹腔镜经验水平（E = 专家，N = 新手）。结果。对于简单的任务，ROB 技术速度较慢且误差较高，并且外科医生的手臂抬得更高。对于复杂的任务，ROB 肌电信号较低。 ROB 的两项任务中的压力均较低，但降低程度不具有统计学意义。结论。对于简单的任务，机器人技术似乎比腹腔镜技术更慢、更不精确，但对于复杂的任务来说，机器人技术速度更快，压力可能更小。以前的腹腔镜经验对机器人手术的身心适应有着复杂的影响。 (c) 2006 Elsevier Inc. 保留所有权利。
Background. This study compares the mental and physical workload of laparoscopic and robotic technique while performing simulated surgical tasks in a laboratory setting.Materials and methods. Ten volunteer surgeons performed two tasks in a laparoscopic trainer using laparoscopic (LAP) and robotic (ROB) techniques. Outcome measures included: Task time, task-error, vertical/horizontal arm displacement, percent maximum electromyographic signal from the thenar, forearm flexor, and deltoid muscle compartments, skin conductance, and perceived difficulty and discomfort levels. A two-way repeated-measures ANOVA compared surgical technique and laparoscopic experience level (E = expert, N = novice).Results. For the simple task, ROB technique was slower and had higher errors, and the surgeon's arm was more elevated. For the complex task, ROB electromyographic signal was lower. Stress was lower in both tasks for ROB, but the decrease was not statistically significant.Conclusions. Robotic technique appears slower and less precise than laparoscopic technique for simple tasks, but equally fast and possibly less stressful for complex tasks. Previous laparoscopic experience has a complex influence on the physical and mental adaptation to robotic surgery. (c) 2006 Elsevier Inc. All rights reserved.