An Updated Physician Workforce Model Predicts a Shortage of Vascular Surgeons for the Next 20 Years

Go, Michael R.; Oslock, Wendelyn M.; Way, David P.; Baselice, Holly E.; Tamer, Robert; Kent, K. Craig; Williams, Thomas E.; Satiani, Bhagwan

doi:10.1016/j.avsg.2020.01.097

Cited by 47 publications

(16 citation statements)

References 16 publications

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“…In contrast, it is unclear whether RALS also has a significantly positive effect on ergonomics and subsequently on a surgeon`s risk for (work-related) musculoskeletal disorders [(WR)MSD]. The latter might be one of several reasons why a lack of active surgeons is expected in the near future [ 25 , 26 ]. Accordingly, under the assumption that robotics may help to reduce WRMSD, valid data is necessary for hospitals` CEOs and controllers to justify the implementation of relatively costly robotic systems with the intention of maintaining or even attracting a stable number of surgical staff and to fulfil their potential fiduciary duties.…”

Section: Discussionmentioning

confidence: 99%

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Krämer

Neis

Reisenauer

et al. 2022

Arch Gynecol Obstet

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Purpose Conventional laparoscopic surgery (CLS) imposes an increased risk of work-related musculoskeletal disorders. Technical innovations, such as robotic-assisted laparoscopic surgery (RALS), may provide ergonomic benefits. We compare the surgeon`s work-related demands of CLS vs RALS for benign hysterectomies. Methods Five specialists (3 females, 2 males) each performed four RALS and four CLS as part of their daily clinical routine. During the surgical procedures, muscular demands were assessed by bipolar surface electromyograms of the descendent trapezius, extensor digitorum and flexor carpi radialis muscles as well as cardio-vascular demands by electrocardiography, and neck, arm and torso posture by gravimetrical position sensors. Additionally, the subjects rated their level of perceived workload (NASA TLX questionnaire with 6 dimension) and musculoskeletal discomfort (11-point Likert-scale, 0–10). Results Muscular demands of the trapezius and flexor carpi radialis muscles were lower with RALS but extensor digitorum demands increased. Cardiovascular demands were about 9 heart beats per minute (bpm) lower for RALS compared to CLS with a rather low median level for both surgical techniques (RALS = 84 bpm; CLS 90 bpm). The posture changed in RALS with an increase in neck and torso flexion, and a reduction in abduction and anteversion position of the right arm. The perceived workload was lower in the physical demands dimension but higher in the mental demands dimension during RALS. Subjective musculoskeletal discomfort was rare during both surgical techniques. Conclusions This explorative study identified several potential ergonomic benefits related to RALS which now can be verified by studies using hypothesis testing designs. However, potential effects on muscular demands in the lower arm extensor muscles also have to be addressed in such studies.

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Section: Discussionmentioning

confidence: 99%

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Krämer

Neis

Reisenauer

et al. 2022

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

“…In contrast, it is unclear whether RALS also has a signi cantly positive effect on ergonomics and subsequently on surgeon`s risk for (work-related) musculoskeletal disorders [(WR)MSD]. The latter might be one of several reasons why a lack of active surgeons is expected in the near future [25,26]. Accordingly, under the assumption that robotics may help to reduce WRMSD, valid data is necessary for hospitals` CEOs and controllers to justify the implementation of relatively costly robotic systems with the intention of maintaining or even attracting a stable number of surgical staff and to ful l their potential duciary duties.…”

Section: Discussionmentioning

confidence: 99%

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Krämer¹,

Neis²,

Reisenauer³

et al. 2022

Preprint

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Purpose: Conventional laparoscopic surgery (CLS) imposes an increased risk of work-related musculoskeletal disorders. Technical innovations, such as robotic-assisted laparoscopic surgery (RALS), may provide ergonomic benefits. We compare the surgeon`s work-related demands of CLS vs RALS for benign hysterectomies. Methods: Five specialists (3 females, 2 males) each performed four RALS and four CLS as part of their daily clinical routine. During the surgical procedures, muscular demands were assessed by bipolar surface electromyograms of the descendent trapezius, extensor digitorum and flexor carpi radialis muscles as well as cardio-vascular demands by electrocardiography, and neck, arm and torso posture by gravimetrical position sensors. Additionally, the subjects rated their level of perceived workload (NASA TLX questionnaire with 6 dimension) and musculoskeletal discomfort (11-point Likert-scale, 0-10). Results: Muscular demands of the trapezius and flexor carpi radialis muscles were lower with RALS but extensor digitorum demands increased. Cardiovascular demands were about 9 heart beats per minute (bpm) lower for RALS compared to CLS with a rather low median level for both surgical techniques (RALS = 84 bpm; CLS 90 bpm). The posture changed in RALS with an increase in neck and torso flexion, and a reduction in abduction and anteversion position of the right arm. The perceived workload was lower in the physical demands dimension but higher in the mental demands dimension during RALS. Subjective musculoskeletal discomfort was rare during both surgical techniques. Conclusions: This explorative study identified several potential ergonomic benefits related to RALS which now can be verified by studies using hypothesis testing designs. However, potential effects on muscular demands in the lower arm extensor muscles also have to be addressed in such studies.

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“…The trained staff is backbone of the specialty. Studies had suggested that USA and UK are also facing shortage of work-force 21,22 . Eastern countries are facing almost similar problems of deficiencies of vascular surgeons and vascular technicians.…”

Section: Discussionmentioning

confidence: 99%

Challenges Faced by Vascular Surgeons in Acceptance of Their Specialty by Medical Community of Pakistan

Jamil

Aman

et al. 2021

PAFMJ

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Objective: To determine the challenges being faced by vascular surgeons in acceptability of their specialty by the medical community of Pakistan. Study Design: Qualitative case study. Place and Duration of Study: Various training institutes & teaching hospitals all over the Pakistan, from Sep 2019 to Feb 2020. Methodology: Semi structured interview format comprising of a series of open ended and broad questions to get maximum relevant information, were sent to 13 surgeons (vascular and part time vascular surgeons) practicing vascular surgery at least for the last five years in various training institutes and teaching hospitals of Pakistan. Interviews were audio recorded on telephone and in persons. The data was transcribed, cleansing was done, and analyzed through inductive and thematic content analysis. Results: Handful of qualified vascular surgeons, inadequate vascular training program, part time vascular surgery and unawareness/misconceptions/myths about vascular diseases, were the major challenges being faced by the vascular community for their separate identity. Conclusion: The vascular community is facing great challenges of shortage of qualified vascular surgeons and technicians, inadequate training centers, part time vascular surgery and misconceptions/myths/unawareness about vascular diseases.

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An Updated Physician Workforce Model Predicts a Shortage of Vascular Surgeons for the Next 20 Years

Cited by 47 publications

References 16 publications

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery

Challenges Faced by Vascular Surgeons in Acceptance of Their Specialty by Medical Community of Pakistan

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