Feasibility and Acceptance of a Robotic Surgery Ergonomic Training Program

Assessment of ergonomic strain during robotic surgery indicates there is a need for intervention. However, limited data exist detailing the feasibility and acceptance of ergonomic training (ET) for robotic surgeons. This prospective, observational pilot study evaluates the implementation of an evidence-based ET module

Obesity Is Associated With Worse Overall Survival in Women With Low-Grade Papillary Serous Epithelial Ovarian Cancer

To evaluate prognostic risk factors for survival in women with low grade serous epithelial ovarian cancer (LGSC)

Feasibility and Acceptance of a Robotic Surgery Ergonomic Training Program

BACKGROUND AND OBJECTIVES: Assessment of ergonomic strain during robotic surgery indicates there is a need for intervention. However, limited data exist detailing the feasibility and acceptance of ergonomic training (ET) for robotic surgeons. This prospective, observational pilot study evaluates the implementation of an evidence-based ET module. METHODS: A two-part survey was conducted. The first survey assessed robotic strain using the Nordic Musculoskeletal Questionnaire (NMQ). Participants were given the option to participate in either an online or an in-person ET session. The ET was derived from Occupational Safety and Health Administration guidelines and developed by a human factors engineer experienced with health care ergonomics. After ET, a follow-up survey including the NMQ and an assessment of the ET were completed. RESULTS: The survey was sent to 67 robotic surgeons. Forty-two (62.7%) responded, including 18 residents, 8 fellows, and 16 attending physicians. Forty-five percent experienced strain resulting from performing robotic surgery and 26.3% reported persistent strain. Only 16.6% of surgeons reported prior ET in robotic surgery. Thirty-five (78%) surgeons elected to have in-person ET, which was successfully arranged for 32 surgeons (91.4%). Thirty-seven surgeons (88.1%) completed the follow-up survey. All surgeons participating in the in-person ET found it helpful and felt formal ET should be standard, 88% changed their practice as a result of the training, and 74% of those reporting strain noticed a decrease after their ET. CONCLUSION: Thus, at a high-volume robotics center, evidence-based ET was easily implemented, well-received, changed some surgeons' practice, and decreased self-reported strain related to robotic surgery

Obesity Is Associated With Worse Overall Survival in Women With Low-Grade Papillary Serous Epithelial Ovarian Cancer

OBJECTIVE: To evaluate prognostic risk factors for survival in women with low grade serous epithelial ovarian cancer (LGSC). METHODS: A multicenter retrospective analysis of patients with LGSC was conducted. Potential epidemiologic risk factors evaluated included obesity, age, parity, race, smoking, oral contraceptive pill and/or hormonal replacement therapy use, and previous hysterectomy or surgery on fallopian tubes and/or ovaries. Additional factors included stage, extent of debulking, residual disease, and disease status. RESULTS: Eighty-one patients were identified, and pathological diagnosis was independently confirmed. Median age of diagnosis was 56 years (range: 21 to 86). Thirty-four percent were obese, and 80% had optimally debulked disease. Forty-six percent were alive, 14% with disease; while 25% were dead of disease; 2% died of intercurrent disease; and 27% had an unknown status. In a univariate analysis, optimal surgical debulking was associated with improved PFS (p=0.01), DSS (p=0.03), and OS (p<0.001 and BMI with worse OS (p=0.05). On multivariate analysis, obesity (HR=2.8; 95% CI=1.05-7.3; p=0.04) and optimal tumor debulking (HR=0.05; 95% CI=0.008-0.29; p=0.001) were a significant predictor of OS. CONCLUSIONS: In a multivariate analysis, obesity and optimal tumor cytoreduction were significant predictors of OS. However, obesity was not associated with worse DSS, suggesting that mortality of obese patients with LGSC may result from other co-morbidities. Interventions addressing obesity may improve survival for women diagnosed with LGSC and further study is warranted to address the role of obesity in LGSC

Ergonomics in surgical environments

The majority of work-related musculoskeletal disorders (WRMDs) in surgery are mostly related to sustained position and awkward postures, forcing non-natural gestures in surgeon ́s body.This arti- cle points to describe the different ailments studied during surgical tasks over the years: causes which increase the discomfort and fatigue, and effects related with them, in order highlight the cur- rent working conditions and how might be improved. To do that, a research is done to understand the main issues related on full body ailments and how is have been evaluated in different types of surgery, for which, the lead postural analysis technologies are presented, understanding Rapid Upper Limb Assessment system (RULA) the most suitable method to stablish priorities for preven- tive/corrective actions.Knowing the ailment ́s causes it have been necessary to define the critical points related with the causes, as instrumentation design, regulations in operating tables and chairs, pedal drives, and other surgical elements that require a ergonomic improvements, so that, the main design guidelines have been col- lected in this document and have been compared with a sample of current products available in the market, with the purpose of knowing the degree of implication between the requirements re- quested by the surgical teams and the companies dedicated to their design