Ergonomic assessment of the da Vinci console in robot-assisted surgery

BACKGROUND: Robot-assisted surgery is considered to improve ergonomics over standard endoscopic surgery. Nevertheless, previous research demonstrated ergonomic deficits in the current console set-up. AIM: This study was designed to objectively assess body posture in the da Vinci console during robot-assisted endoscopic surgery. METHODS: Multiple sagittal photographs from six physicians were taken during robot-assisted procedures. Trunk, neck, shoulder, elbow, hip, and knee angles were calculated and compared to ergonomic preferable joint angles. A 2D geometric model was developed using individual anthropometrics. Optimal seat height, armrest height, and viewer height were calculated. These results were compared to the findings of the sagittal photographs. RESULTS: Mean joint angles show potentially harmful neck angles for all participants. Trunk angles vary between surgeons, from inadequate to correct. In short and very tall individuals, optimal armrest height is outside the adjustment range of the console. CONCLUSION: The da Vinci Surgical System console seating position results in a nonergonomic neck and trunk angle. The developed geometric model revealed that armrest height has a limited adjustment range. Adjustments to the console and optimization of preoperative settings are goals to further improve ergonomics in robot-assisted surgery.