Ergonomics in robot-assisted surgery in comparison to open or conventional laparoendoscopic surgery: A narrative review

Although often forgotten in everyday routine and underestimated, especially in a surgical work environment, ergonomics are essential for endurance, efficiency, and a long and healthy work life. According to current studies, the rate of musculoskeletal disorders among minimally invasive surgeons ranges between 23% and 80%, which is lower compared with open surgery (66%-94%), but nevertheless shows the everyday relevance of this topic. An efficient and ergonomic design of the operating room has been widely discussed and guidelines have been imposed to create the optimal workspace. Furthermore, with the implementation of technical advancements and the introduction of robotic operating techniques, ergonomics have become an essential differentiating factor between systems. Surgical ergonomics are not universal but differ between open, laparoscopic, and robotic surgery. With the introduction of new robotic systems, many ergonomic challenges faced in open and laparoscopic surgeries have been overcome, whereas new challenges have been created. Nevertheless, ergonomics in surgery will need to be addressed and taken seriously, as a healthy workspace has gained more importance than ever.