How the RoboticScope can change otological surgery

Improving Surgical Ergonomics

Work-related musculoskeletal disorders (WRMDs) are an unwelcome reality for many surgeons, but for otologists, the problem is particularly acute. The sustained, awkward postures required during long hours at the operating microscope can take a serious toll, leading to pain, fatigue, and even early retirement.

 

The recent pilot study „Ergonomics of 3D-Exoscope Versus the Operating Microscope in Otologic Surgery“ by Prof. Payal Mukherjee, Dr. Ankit Ajmera, Prof. Raewyn Campbell, Dr. Jennifer Lee, and Dr. Samuel McGinness, published in the ANZ Journal of Surgery, takes a closer look at the RoboticScope. The findings suggest a significant ergonomic advantage over the traditional operating microscope in major otologic procedures.

The Challenge: Ergonomics in Otologic Surgery

Otolaryngologists spend much of their careers in high-risk postures, with studies showing that up to 97% experience WRMD symptoms. The problem starts early—up to 93% of otolaryngology trainees with less than five years of experience already report similar issues. In otologic surgery, the operating microscope often forces prolonged neck flexion and static positioning—both key contributors to musculoskeletal strain. (Ajmera et al., 2025)

The Study

The research team conducted a prospective ergonomic analysis at a single center, comparing nine surgeries performed with a traditional operating microscope and nine with the RoboticScope.

 

Two key tools measured outcomes:

  • Rapid Upper Limb Assessment (RULA) – an objective ergonomic risk score from 1 (low risk) to 7 (high risk).
  • NASA Task Load Index-based Questionnaire – a subjective assessment of physical strain, effort, cognitive load, and device usability, using a 1–9 Likert scale (1 = strongly disagree, 5 = neutral, 9 = strongly agree).

 

Surgeons were also asked to evaluate image quality, ease of use, and the system’s educational value. (Ajmera et al., 2025)

The Results

  • Lower Ergonomic Risk: – RULA score 4.0 (low risk) with the RoboticScope vs. 5.9 (moderate risk) with the microscope.

  • Reduced Physical Strain: With the RoboticScope there were significant reductions in fatigue/effort (Likert score 4 vs. 3.5; p = 0.015), physical strain (Likert score 6.73 vs. 2.63; p = 0.008), and weakness (Likert score 6.5 vs. 2.75; p = 0.01).

  • Natural Posture: Surgeons reported a more natural posture with the RoboticScope

  • Image & Education: Positive ratings for image quality, magnification, color contrast, and strong educational value.

  • No adverse patient events.

    (Ajmera et al., 2025)

Why It Matters

In this pilot study, surgeons reported a more natural posture and lower ergonomic risk when using the RoboticScope compared to the operating microscope. Combined with its Head-Mounted Display and DualView capability, the system offers:

 

  • Neutral head and neck positions
  • Greater comfort in long cases
  • Shared 3D vision for enhanced surgical teaching

(Ajmera et al., 2025)

Looking Ahead

This study reinforces what many surgeons have already experienced: the RoboticScope can transform the ergonomics of otologic surgery without compromising surgical performance. By enabling a neutral posture and shared 3D visualization, it not only protects surgeons from the physical toll of their work but also enhances training for the next generation.

 

As healthcare systems face workforce shortages and an aging surgical population, innovations that reduce injury risk are more than just technological upgrades—they are investments in the future of surgical care.

 

 

Read the full study here: A. Ajmera, R. G. Campbell, J. W. Y. Lee, S. J. McGinness, and P. Mukherjee, “ Ergonomics of 3D-Exoscope Versus the Operating Microscope in Otologic Surgery,” ANZ Journal of Surgery (2025): 1–7, https://doi.org/10.1111/ans.70278.