Background: This study aimed to obtain an answer for the question: Are ergonomic guidelines applied in the operating room and what are the consequences? Methods: A total of 1,292 questionnaires were sent by email or handed out to surgeons and residents. The subjects worked mainly in Europe, performing laparoscopic and/or thoracoscopic procedures within the digestive, thoracic, urologic, gynecologic, and pediatric disciplines. Results: In response, 22% of the questionnaires were returned. Overall, the respondents reported discomfort in the neck, shoulders, and back (almost 80%). There was not one specific cause for the physical discomfort. In addition, 89% of the 284 respondents were unaware of ergonomic guidelines, although 100% stated that they find ergonomics important. Conclusion:The lack of ergonomic guidelines awareness is a major problem that poses a tough position for ergonomics in the operating room.

ObjectiveTo assess surgical team members’ differences in perception of non-technical skills.DesignQuestionnaire design.SettingOperating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands.ParticipantsSixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists.MethodsAll surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT.ResultsRatings for ‘communication’ were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for ‘teamwork’ differed significantly between all team members (P ≤ 0.005). Within ‘situation awareness’ significant differences were mainly observed for ‘gathering information’ between surgeons and other team members (P < 0.001). Finally, 72–90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate.ConclusionsThis study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

Operative notes do not adequately represent the actual LCs performed as they describe fewer important procedural steps. It is suggested that operative notes should include video recordings.