Minimally invasive Distal Pancreatectomy eRgonOMic analysis – the DP-ROM trial: An explorative, prospective, observational, cohort study trial

作者：Matteo De Pastena, Salvatore Paiella, Alessandro Esposito, Elisa Venturini, Ermes Vedovi, Massimo Strazzer, Carlo Caselli, Giuseppe Malleo, Gabriella Lionetto, Antonio Pea, Luca Landoni, Elisa Danese, Roberto Salvia · 发表于：Surgical Endoscopy · 年份：2025 · DOI：10.1007/s00464-025-12227-w · 被引用次数：3 · 研究领域：Surgical Simulation and Training、Augmented Reality Applications、Pancreatic and Hepatic Oncology Research

BACKGROUND: Minimally invasive distal pancreatectomy (DP) improves patient outcomes but also introduces significant ergonomic challenges for surgeons. This study quantitatively compares the ergonomic stress and mental workload associated with laparoscopic versus robot-assisted DP. METHODS: An exploratory, prospective, observational cohort trial was conducted with two experienced pancreatic surgeons performing 20 DPs (10 laparoscopic using IMAGE1 S Rubina and 10 robot-assisted using da Vinci® Si platform). Ergonomic stress was assessed using stabilometric analysis, kinematic pelvic movement analysis, ocular examinations, cortisol level monitoring, and the NASA Task Load Index (NASA-TLX). RESULTS: Robot-assisted DP demonstrated superior ergonomic performance, with reduced physical and mental demands compared to laparoscopic DP. Stabilometric tests indicated significantly greater postural stability during robot-assisted surgery, characterized by lower variance in body oscillations. Kinematic analyses confirmed smoother pelvic movements in robot-assisted procedures, suggesting reduced physical fatigue. Visual strain was markedly higher during laparoscopic surgery, likely due to prolonged screen exposure. The NASA-TLX indicated significantly lower overall workload scores for robot-assisted DP (35.3 ± 19.5) compared to laparoscopic DP (50.7 ± 21.7, p = 0.04). Cortisol analyses consistently showed elevated stress levels in the laparoscopic group compared to the robotic group, reinfo...