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Stefan et al. Mini-invasive Surg 2021;5:23 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.24

Technical note Open Access

Ergonomics in robotic surgery: patients’ safety and

protection during complex procedures

2
1
Samuel S. Stefan , Yousra Ahmad , Jim S. Khan 1,3
1
Colorectal Department, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
2
Anaesthetics Department, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
3
School of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1 1PT, UK.
Correspondence to: Dr. Jim S. Khan, Colorectal Department, Queen Alexandra Hospital, Southwick Hill Road, Cosham,
Portsmouth PO6 3LY, UK. E-mail: Jim.Khan@porthosp.nhs.uk
How to cite this article: Stefan SS, Ahmad Y, Khan JS. Ergonomics in robotic surgery: patients’ safety and protection during
complex procedures. Mini-invasive Surg 2021;5:23. https://dx.doi.org/10.20517/2574-1225.2021.24
Received: 23 Feb 2021 First Decision: 12 Mar 2021 Revised: 12 Mar 2021 Accepted: 24 Mar 2021 Published: 8 May 2021

Academic Editor: Simon Ng Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Specific injuries due to poor positioning seen in robotic pelvic surgery include slips, compartment syndrome, facial
oedema, injuries on pressure points, and accidental injuries caused by the robotic arms. The use of the vacuum
bean-bag positioner, L-bar against the patient’s face, and inflated gloves for hand support are simple and effective
techniques and should be included in the standard operating policies for robotic surgery. We recommend use of
the “L” shaped safety bar against the patient’s face to ensure protection against accidental injuries caused by the
robotic arms. The anti-slip bean-bag mattress is efficient to prevent slipping; it conforms to the shape of the body
for stable positioning and allows extremities to lie in a natural position. Protection of pressure points of hands and
elbows can be done with inflated medical gloves placed in the patient’s hands. Surgeons, anaesthetists and theatre
teams are together responsible for ensuring that safety measures are in place to reduce the risk of these
complications.

Keywords: Robotic surgery, ergonomics, intraoperative injuries, positional complications

The last decade has seen some significant technological advances in surgery, leading to improved outcomes;
however, as with every new technique there is an associated learning curve, which often entails longer
operating times. The patients are usually placed in steep Trendelenburg and tilted positions in pelvic
surgery. It is extremely important to ensure that the patients do not slip off the operating table during these

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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