Should all minimal access surgery be robot-assisted?:A systematic review into the musculoskeletal and cognitive demands of laparoscopic and robot-assisted laparoscopic surgery

Shugaba, Abdulwarith and Lambert, Joel and Bampouras, Theo and Nuttall, Helen E and Gaffney, Christopher and Subar, Daren (2022) Should all minimal access surgery be robot-assisted?:A systematic review into the musculoskeletal and cognitive demands of laparoscopic and robot-assisted laparoscopic surgery. Journal of Gastrointestinal Surgery. ISSN 1873-4626 (In Press)

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Abstract

Background: Surgeons are amongst the most at risk of work-related musculoskeletal health decline because of the physical demands of surgery, which is also associated with cognitive fatigue. Minimally invasive surgery offers excellent benefits to patients but the impact of robotic or laparoscopic surgery on surgeon well-being is less well understood. This work examined the musculoskeletal and cognitive demands of robot-assisted versus standard laparoscopic surgery. Methods: Medline, Embase, and Cochrane databases were systematically searched for “Muscle strain” AND “musculoskeletal fatigue” AND “occupational diseases” OR “cognitive fatigue” AND “mental fatigue” OR “standard laparoscopic surgery” AND “robot-assisted laparoscopic surgery”. Primary outcomes measured were electromyographic (EMG) activity for musculoskeletal fatigue and questionnaires (NASA TLX, SMEQ, or Borg CR-10) for cognitive fatigue. A systematic review was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) Guidelines. The study was preregistered on Prospero ID: CRD42020184881. Results: Two hundred and ninety-eight original titles were identified. Ten studies that were all observational studies were included in the systematic review. EMG activity was consistently lower in robotic than in laparoscopic surgery in the erector spinae and flexor digitorum muscles but higher in the trapezius muscle. This was associated with significantly lower cognitive load in robotic than laparoscopic surgery in 7 of 10 studies. Conclusions: Evidence suggests a reduction in musculoskeletal demands during robotic surgery in muscles excluding the trapezius, and this is associated with most studies reporting a reduced cognitive load. Robotic surgery appears to have less negative cognitive and musculoskeletal impact on surgeons compared to laparoscopic surgery.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Gastrointestinal Surgery
ID Code:
168072
Deposited By:
Deposited On:
29 Mar 2022 15:25
Refereed?:
Yes
Published?:
In Press
Last Modified:
04 May 2022 02:52