{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:33:45Z","timestamp":1786707225721,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Robotic-assisted surgery has transformed minimally invasive surgery by enhancing dexterity, visualisation and surgeon ergonomics. However, significant variations exist in robotic console architecture, primarily between open-console and closed-console systems. Although robotic surgery is generally considered to offer ergonomic benefits over laparoscopic surgery, evidence comparing ergonomic outcomes between console designs remains limited. To compare the ergonomic impact of open- versus closed-console robotic systems on surgeon fatigue, musculoskeletal strain and workload.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n A prospective, randomised, crossover wet-lab study was conducted involving surgeons performing standardised robotic surgical tasks on both open-console and closed-console robotic systems. Ergonomic outcomes were assessed using Rapid Upper Limb Assessment (RULA), NASA Task Load Index (NASA-TLX) and subjective fatigue scales.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Open-console systems demonstrated significantly lower RULA scores and improved ergonomic posture compared with closed-console systems (\n P<\/jats:italic>\n < 0.05). Surgeons reported reduced neck, shoulder and upper back discomfort after open-console use. NASA-TLX scores revealed lower physical demand, effort and frustration with open-console systems. No statistically significant difference in surgical precision or error rates was observed between the systems.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Open-console robotic systems provide superior ergonomic advantages compared with closed-console robotic systems, reducing surgeon fatigue and musculoskeletal strain without compromising technical performance. Console architecture should be recognised as a major determinant of surgeon occupational health and future robotic platform design.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_265_26","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:00:19Z","timestamp":1786705219000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ergonomic impact of open- versus closed-console robotic systems on surgeon fatigue and musculoskeletal strain: A prospective, experimental, wet-lab comparative study"],"prefix":"10.4103","author":[{"given":"Bhavneet Singh","family":"Bhalla","sequence":"first","affiliation":[{"name":"Department of Minimal Access Surgery, World Laparoscopy Hospital, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrita","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Paramedical Sciences, NIILM University, Kaithal, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Surgery, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"R1-20260814","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/01.sla.0000103020.19595.7d","article-title":"Robotic surgery: A current perspective","volume":"239","author":"Lanfranco","year":"2004","journal-title":"Ann Surg"},{"key":"R3-20260814","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s00464-007-9727-5","article-title":"SAGES-MIRA Robotic Surgery Consensus Group. A consensus document on robotic surgery","volume":"22","author":"Herron","year":"2008","journal-title":"Surg Endosc"},{"key":"R4-20260814","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.amsu.2017.12.013","article-title":"Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics","volume":"27","author":"Stucky","year":"2018","journal-title":"Ann Med Surg (Lond)"},{"key":"R5-20260814","first-page":"97","article-title":"Ergonomic assessment of the da Vinci console in robot-assisted surgery","volume":"2","author":"Van't Hullenaar","year":"2017","journal-title":"Innov Surg Sci"},{"key":"R7-20260814","author":"Krauss","year":"2026","journal-title":"Ergonomics in Robotics: A Practical Guide Central Journal of Surgery \u2013 Journal for General, Visceral, Thoracic, and Vascular Surgery"},{"key":"R8-20260814","first-page":"p. 1","article-title":"Overview of Existing Robotic Platforms","author":"Flores","year":"2021","journal-title":"Atlas of Robotic General Surgery E-Book"},{"key":"R9-20260814","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0003-6870(93)90080-S","article-title":"RULA: A survey method for the investigation of work-related upper limb disorders","volume":"24","author":"McAtamney","year":"1993","journal-title":"Appl Ergon"},{"key":"R10-20260814","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0166-4115(08)62386-9","article-title":"Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research","volume":"52","author":"Hart","year":"1988","journal-title":"Adv Psychol"},{"key":"R11-20260814","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1245\/s10434-022-12548-3","article-title":"Ergonomic assessment of the surgeon's physical workload during robot-assisted versus standard laparoscopy in a french multicenter randomized trial (ROBOGYN-1004 Trial)","volume":"30","author":"Hotton","year":"2023","journal-title":"Ann Surg Oncol"},{"key":"R12-20260814","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00464-002-9105-2","article-title":"Ergonomic problems encountered by the medical team related to products used for minimally invasive surgery","volume":"17","author":"van Veelen","year":"2003","journal-title":"Surg Endosc"},{"key":"R13-20260814","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1007\/s00464-003-8922-2","article-title":"Dexterity enhancement with robotic surgery","volume":"18","author":"Moorthy","year":"2004","journal-title":"Surg Endosc"},{"key":"R14-20260814","doi-asserted-by":"crossref","first-page":"e174947","DOI":"10.1001\/jamasurg.2017.4947","article-title":"Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: A systematic review and meta-analysis","volume":"153","author":"Epstein","year":"2018","journal-title":"JAMA Surg"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_265_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:00:20Z","timestamp":1786705220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_265_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":12,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_265_26","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"assertion":[{"value":"2026-05-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}