Abstract
<title>Abstract</title> <p>Background Robotic surgery has been associated with improved ergonomics compared with conventional laparoscopy. However, most studies have focused on the console surgeon, and its impact on the entire surgical team remains poorly understood. Methods We conducted a cross-sectional study including robotic and conventional laparoscopic esophagogastric and colorectal procedures performed between September 2024 and March 2025. After each operation, primary surgeon and surgical assistants completed a structured questionnaire assessing musculoskeletal symptoms, posture, comfort, fatigue, and cognitive workload. Multivariable linear regression models adjusted for perceived procedural complexity and operative duration were performed for each ergonomic domain, with linear mixed-effects models used as sensitivity analyses. Results Ninety-two procedures were included. Questionnaires were completed by primary surgeons in 73 procedures (79.3% response rate) and by surgical assistants in 146 assessments. Compared with conventional laparoscopy, robotic surgery was independently associated with lower back, neck, shoulder, hand, and lower-limb pain, improved posture, greater comfort, and less physical fatigue among primary surgeons. Similar improvements were observed among surgical assistants. The results remained consistent in sensitivity analyses. Conclusions Robotic surgery was associated with a lower perceived ergonomic burden than conventional laparoscopy across different members of the surgical team. These findings suggest that the ergonomic benefits of robotic platforms extend beyond the console surgeon and support evaluating robotic surgery from a team-based ergonomic perspective.</p>