The ergonomic impact of robotic vs. laparoscopic surgery on operating room nurses: A multicenter survey analysis

Abstract

Objective: Robotic surgery is increasingly used across specialties, yet its ergonomic impact on operating room nurses remains underexplored. This multicenter study aimed to evaluate the ergonomic challenges and musculoskeletal discomfort among scrub nurses during robotic surgery and to compare these outcomes with laparoscopic procedures, with additional analysis based on years of robotic surgery experience. Material and Methods: This cross-sectional, multicenter, questionnaire-based study was conducted between January and February 2025, among scrub nurses with experience in robotic surgery from multiple centers. Ergonomic perceptions, physical strain, musculoskeletal discomfort, and comparisons between robotic and laparoscopic surgery were assessed. Nurses were stratified into less than and more than 5 years of robotic surgery experience, and comparative statistical analyses were performed. Results: Most nurses rated the robotic operating environment as comfortable (69.6%), and 56.4% reported reduced workload compared with laparoscopy. Physical strain was reported by 30.9%, most commonly during instrument exchange. Musculoskeletal discomfort predominantly affected the neck, back, and shoulders. Shoulder pain was significantly more common among nurses with >5 years of experience (70% vs. 33.3%, p=0.008). Although 71.4% reported ergonomic support from robotic systems, 85.7% had not received ergonomic training. Conclusion: Robotic surgery is perceived by scrub nurses as ergonomically more favorable than laparoscopic surgery; however, substantial musculoskeletal discomfort persists, particularly among more experienced nurses and in the absence of ergonomic training. These findings suggest a potential cumulative ergonomic burden and highlight the need for structured ergonomic education and system-level interventions.